Constance Grace Mullis, RDN, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Practice address

1 E Erie St Ste 242
Chicago, IL 60611-2737

Phone

(312) 964-4674

NPI assigned

Sep 7, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Connie Mullis Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Pathlight Neuropsychiatric Center LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Chicago, IL
  • NPI 1578233409
  NPD
• Pathlight Neuropsychiatric Center LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Denver, CO
  • NPI 1629647367
  NPD (past)

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1194501833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E ERIE ST STE 242",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112737",
            "telephone_number": "312-964-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E ERIE ST STE 242",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112737",
            "telephone_number": "312-964-4674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 E Huron St Ste 1300",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112999",
            "country_code": "US",
            "telephone_number": "312-964-4674 x57674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLIS",
        "first_name": "CONSTANCE",
        "middle_name": "GRACE",
        "credential": "RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "MULLIS",
            "credential": "RDN, LDN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Janie L Mullins, MOT
• Julia Morgan Mullins, PA-C
• Kailey Mullins, LCSW
• Morgan Mullins, MS, RDN, LDN
• Catherine Amelia Mullis, PSYD
• Patrick Ryan Mulloy
• Lakshman Mulpuri, MD
• Jenna Quill Mulroe, APN
• Megan Mulroy, LPC
• Eleanor Claire Mulshine I, LCSW

• Registered Dietitian in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.