Active NPI
Stephanie Ineman, MS, RDN, LDN
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1134620941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 6731
- Practice address
- 70 E Lake St Ste 226
Chicago, IL 60601-7650 - Phone
- (866) 710-1018
- NPI assigned
- Feb 27, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 6731 | OH | Primary |
Addresses
Primary practice location
70 E Lake St Ste 226
Chicago, IL 60601-7650
Mailing address
260 Meadow Ridge TRL
Doylestown, OH 44230-1636
Phone (330) 933-9522
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6731 | OH | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Base10 Genetics, LLC | Current | Accepting new patients |
Locations
70 E Lake St
Ste 226
Chicago, IL 60601
Phone (866) 710-1018
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.
-
- Family Medicine Physician
- Chicago, IL
- NPI 1477158020
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649203200000",
"number": "1134620941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 MEADOW RIDGE TRL",
"city": "DOYLESTOWN",
"state": "OH",
"postal_code": "442301636",
"telephone_number": "330-933-9522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 E LAKE ST STE 226",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606017650",
"telephone_number": "866-710-1018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INEMAN",
"first_name": "STEPHANIE",
"credential": "MS, RDN, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-27",
"last_updated": "2022-04-06",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OH",
"license": "6731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.