Individual provider Active NPI

Lorissa Sernus, RDN, LDN

  • Registered Dietitian
  • Worth, IL
National Provider Identifier
1124637392
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
10746 S Nagle Ave
Worth, IL 60482-1613
Phone
(708) 642-7767
NPI assigned
Jul 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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 IL Primary

Addresses

Primary practice location

10746 S Nagle Ave
Worth, IL 60482-1613

Mailing address

10746 S Nagle Ave
Worth, IL 60482-1613
Phone (708) 642-7767

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1124637392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10746 S NAGLE AVE",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604821613",
            "telephone_number": "708-642-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10746 S NAGLE AVE",
            "city": "WORTH",
            "state": "IL",
            "postal_code": "604821613",
            "telephone_number": "708-642-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERNUS",
        "first_name": "LORISSA",
        "credential": "RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worth, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.