Stephanie Renee Marsh, RD, LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164005394 Issued in IL

Practice address

701 W North Ave
Melrose Park, IL 60160-1699

Phone

(708) 538-4689

NPI assigned

Aug 10, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1255610044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 N VIRGINIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606594875",
            "telephone_number": "810-923-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601699",
            "telephone_number": "708-538-4689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5320 159th St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Oak Forest",
            "state": "IL",
            "postal_code": "604524705",
            "country_code": "US",
            "telephone_number": "708-798-8112 x247",
            "fax_number": "708-535-6396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSH",
        "first_name": "STEPHANIE",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-10",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164005394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164005394",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Merissa Mann, P.A.-C
• Manuel Cesar Iglesias, M.D., S.C.
• Fred J. Marchese, D.D.S.
• Marie Theresa Marek, CADC
• Daniel Marsh, LPC
• Xavier Martillo
• Paul Martin, LCPC
• Andres Rudolfo Martinez II
• Bryan Martinez
• Esther Martinez

• Registered Dietitian in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.