Active NPI
Marla Crill Heller, R.D.
- Registered Dietitian
- Great Lakes, IL
National Provider Identifier
1144278557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 12402811
- Practice address
- 3001 6TH St
A
Great Lakes, IL 60088-2833 - Phone
- (847) 480-7698
- Fax
- (847) 681-9748
- NPI assigned
- May 5, 2006
- 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 | 12402811 | IL | Primary |
Addresses
Primary practice location
3001 6TH St
A
Great Lakes, IL 60088-2833
Mailing address
3001 6TH St
Great Lakes, IL 60088-2833
Phone (847) 480-7698
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12402811 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193356800000",
"number": "1144278557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 6TH ST",
"city": "GREAT LAKES",
"state": "IL",
"postal_code": "600882833",
"telephone_number": "847-480-7698",
"fax_number": "847-681-9748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 6TH ST",
"address_2": "A",
"city": "GREAT LAKES",
"state": "IL",
"postal_code": "600882833",
"telephone_number": "847-480-7698",
"fax_number": "847-681-9748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HELLER",
"first_name": "MARLA",
"middle_name": "CRILL",
"credential": "R.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-05",
"last_updated": "2007-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "12402811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Lakes, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.