Individual provider Active NPI

Diane Francine Coli, REGISTERED DIETITIAN

  • Registered Dietitian
  • Lisle, IL
National Provider Identifier
1124661129
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164007444 Issued in IL
Practice address
4271 Black Oak Drive
Lisle, IL 60532-6053
Phone
(630) 624-3378
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X
Registered Dietitian 133V00000X 86090210 IL
Sports Dietetics Nutrition Registered Dietitian 133VN1501X
Health Educator 174H00000X
Athletic Trainer 2255A2300X
Registered Dietitian 133V00000X 164007444 IL Primary

Addresses

Primary practice location

4271 Black Oak Drive
Lisle, IL 60532-6053

Mailing address

4271 Black Oak Drive
Lisle, IL 60532
Phone (630) 624-3378

Other identifiers 1

IdentifierTypeStateIssuer
SSNOtherILBLUE CROSS BLUE SHIELD, UNITED HEALTH CARE,

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013000211 IL Practitioner - Registered Dietitian Or Nutrition Professional 7618322447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

25 N Winfield Rd
Winfield, IL 60190-1295
Phone (630) 933-2113

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
164007444ILMDRegistered Dietitian
86090210ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Sep 1, 2023 Accepting new patients
Central Dupage Physician Group CurrentSince Sep 1, 2023 Accepting new patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

25 N Winfield Rd
Ste 520
Winfield, IL 60190
Phone (630) 933-6930

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1124661129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4271 BLACK OAK DRIVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "60532",
            "telephone_number": "630-624-3378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4271 BLACK OAK DRIVE",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605326053",
            "telephone_number": "630-624-3378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLI",
        "first_name": "DIANE",
        "middle_name": "FRANCINE",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "86090210",
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164007444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD, UNITED HEALTH CARE,",
            "identifier": "SSN",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.