Miranda Lee Andres, RDN
Individual provider Active NPI Registered Dietitian · Chicago, IL
NPI 1184200818 · NPPES record last updated Mar 23, 2021
Key facts
- NPI
- 1184200818
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 164008324 (IL)
- Practice address
- 2551 N Clark St Ste 400
Chicago, IL 60614-7725 - Phone
- (312) 533-1754
- NPI assigned
- Mar 23, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Health Loft PLLC
Practice addresses (Care Compare)
2027 W Division St
Suite 120
Chicago, IL 60622-9024
Phone (855) 552-5557
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231109003179 | IL | Practitioner - Registered Dietitian Or Nutrition Professional | 0244687481 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Loft PLLC | Dietitian, Registered | Current |
Accepting new patients |
| Healthier Tomorrows, PLLC | Dietitian, Registered | Current |
Accepting new patients |
| Health Loft Services LLC | Dietitian, Registered | Past |
Accepting new patients |
Locations
2551 N Clark St
Ste 400
Chicago, IL 60614
Phone (312) 533-1754
160 N Wacker Dr
Ste 201
Chicago, IL 60606
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164008324 | IL | Yes |
Addresses
Primary practice location
2551 N Clark St Ste 400
Chicago, IL 60614-7725
Mailing address
2065 N Hoyne Ave Apt 3M
Chicago, IL 60647-4759
Phone (636) 293-8184
Other providers in Chicago, IL
- Mia Andreoli
- Sarafina Andreoli
- Andres O. Botuyan MD., SC
- Genevieve Marie Andres
- Herberth Andres
- Olivia Andres
- Rosemarie Andres
- Kaori I Andresen
- Katelyn Andresen
- Ryan Michael Andresen
All providers in Chicago, IL · Registered Dietitian in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.