NPIMap

Organization Active NPI

Conway Nutrition Services, Inc.

  • Registered Dietitian
  • Oak Forest, IL
National Provider Identifier
1154785442
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.001485 Issued in IL
Legal business name
CONWAY NUTRITION SERVICES, INC.
Practice address
5328 Fawn CT
Oak Forest, IL 60452-2200
Phone
(708) 305-4402
Fax
(708) 535-2268
NPI assigned
Apr 12, 2016
Last updated
Apr 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Authorized official

Name
Jennifer W ConwayNPI 1992821219
Title
Owner/Director
Phone
(708) 305-4402

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 164.001485 IL Primary

Addresses

Primary practice location

5328 Fawn CT
Oak Forest, IL 60452-2200

Mailing address

5328 Fawn CT
Oak Forest, IL 60452-2200
Phone (708) 305-4402

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1154785442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5328 FAWN CT",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522200",
            "telephone_number": "708-305-4402",
            "fax_number": "708-535-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5328 FAWN CT",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522200",
            "telephone_number": "708-305-4402",
            "fax_number": "708-535-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY NUTRITION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "CONWAY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "708-305-4402"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.001485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.