Active NPI
Allison Parker Koch, RDN, CSSD
- Registered Dietitian
- Park Ridge, IL
National Provider Identifier
1194376244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164006301
- Practice address
- 826 W Touhy Ave
Park Ridge, IL 60068-3352 - Phone
- (847) 825-0070
- Fax
- (312) 648-0155
- NPI assigned
- Sep 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 164006301 | IL | Primary |
Addresses
Primary practice location
826 W Touhy Ave
Park Ridge, IL 60068-3352
Mailing address
619 W Jackson Blvd
Chicago, IL 60661-5606
Phone (847) 825-0770
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 |
|---|---|---|---|
| 164006301 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fitness Formula, LTD | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568937600000",
"number": "1194376244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 W JACKSON BLVD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606615606",
"telephone_number": "847-825-0770",
"fax_number": "312-648-0155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "826 W TOUHY AVE",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600683352",
"telephone_number": "847-825-0070",
"fax_number": "312-648-0155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "ALLISON",
"middle_name": "PARKER",
"credential": "RDN, CSSD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-20",
"last_updated": "2019-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164006301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.