Kimberly Jurkowski, RDN

Primary specialty

Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X

License

164.003975 Issued in IL

Practice address

640 Rosedale Ave
Roselle, IL 60172-2980

Phone

(630) 220-7666

NPI assigned

Apr 15, 2020

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

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Real Food Nutrition, LLC

  • Registered Dietitian
  • Roselle, IL
  • NPI 1043817497
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1255950598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 ROSEDALE AVE",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601722980",
            "telephone_number": "630-220-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 ROSEDALE AVE",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601722980",
            "telephone_number": "630-220-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURKOWSKI",
        "first_name": "KIMBERLY",
        "name_prefix": "Mrs.",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-12-16",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "IL",
            "license": "164.003975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay P. Mueller D.D.S.
• Jeanette Bond Speech Language Cognitive Therapy LLC
• James Johnson, D.C.
• Katelyn J Johnson, MA
• Stephanie C Johnson, D.C
• K and K Counseling
• Zubair Kaleemulla
• William C. Kao, D.D.S.
• Kari Sandy Counseling Corporation
• Harmanmeet Kaur, DMD

• Obesity and Weight Management Nutrition Registered Dietitian in Roselle, IL
• Providers in Roselle, IL by specialty
• Obesity and Weight Management Nutrition Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.