Individual provider Active NPI

Lisa E Wright, MS, RD, LDN

  • Registered Dietitian
  • Chicago Ridge, IL
National Provider Identifier
1124339072
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164005258 Issued in IL
Practice address
10400 Southwest Hwy
Lower Level
Chicago Ridge, IL 60415-1367
Phone
(708) 581-7308
Fax
(708) 581-7309
NPI assigned
Jun 25, 2010
Last updated
Jun 25, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164005258 IL Primary

Addresses

Primary practice location

10400 Southwest Hwy
Lower Level
Chicago Ridge, IL 60415-1367

Mailing address

10400 Southwest Hwy
Lower Level
Chicago Ridge, IL 60415-1367
Phone (708) 581-7308

Other identifiers 1

IdentifierTypeStateIssuer
164005258OtherILSTATE OF ILLINOIS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
164005258ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Uropartners, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1124339072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10400 SOUTHWEST HWY",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604151367",
            "telephone_number": "708-581-7308",
            "fax_number": "708-581-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 SOUTHWEST HWY",
            "address_2": "LOWER LEVEL",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604151367",
            "telephone_number": "708-581-7308",
            "fax_number": "708-581-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "LISA",
        "middle_name": "E",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164005258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ILLINOIS LICENSE",
            "identifier": "164005258",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.