Individual provider Active NPI

Katherine Marusarz, REGISTERED DIETITIAN

  • Renal Nutrition Registered Dietitian
  • Chicago, IL
National Provider Identifier
1205615473
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Renal Nutrition Registered DietitianTaxonomy code 133VN1005X
License
164.006548 Issued in IL
Practice address
233 E 13TH St Apt 405
Chicago, IL 60605-3238
Phone
(630) 334-3237
NPI assigned
Sep 26, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Renal Nutrition Registered Dietitian 133VN1005X 164.006548 IL Primary

Addresses

Primary practice location

233 E 13TH St Apt 405
Chicago, IL 60605-3238

Mailing address

233 E 13TH St Apt 405
Chicago, IL 60605-3238

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

LicenseStateTypeSpecialty
164.006548ILMDRenal Nutrition Registered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1205615473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 E 13TH ST APT 405",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 E 13TH ST APT 405",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053238",
            "telephone_number": "630-334-3237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARUSARZ",
        "first_name": "KATHERINE",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "IL",
            "license": "164.006548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.