Individual provider Active NPI

Nicole S St John, MS, RDN, LDN

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1235085424
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164022311 Issued in IL
Practice address
675 N Saint Clair St Ste 14-200
Chicago, IL 60611-5966
Phone
(312) 695-7382
Fax
(312) 695-0014
NPI assigned
Mar 9, 2026
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164022311 IL Primary

Addresses

Primary practice location

675 N Saint Clair St Ste 14-200
Chicago, IL 60611-5966

Mailing address

675 N Saint Clair St Ste 14-200
Chicago, IL 60611-5966
Phone (312) 695-7382

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260421002752 IL Practitioner - Registered Dietitian Or Nutrition Professional 2163998683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Texas Tech University Health Science Center School of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5777 Dept
Carol Stream, IL 60122-0021

710 N Fairbanks CT
Suite 7 121
Chicago, IL 60611-3013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
164022311ILMDRegistered Dietitian

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1773014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1235085424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 14-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115966",
            "telephone_number": "312-695-7382",
            "fax_number": "312-695-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 14-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115966",
            "telephone_number": "312-695-7382",
            "fax_number": "312-695-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST JOHN",
        "first_name": "NICOLE",
        "middle_name": "S",
        "credential": "MS, RDN, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-09",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164022311",
            "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 Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.