Active NPI
Mary Beth Mora, RDN, LDN, CDCES
- Registered Dietitian
- Maywood, IL
National Provider Identifier
1275440885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 916197
- Practice address
- 15 N 9TH Ave
Maywood, IL 60153-1180 - Phone
- (708) 574-8170
- NPI assigned
- Aug 27, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | IL | ||
| Registered Dietitian | 133V00000X | 916197 | IL | Primary |
Addresses
Primary practice location
15 N 9TH Ave
Maywood, IL 60153-1180
Mailing address
15 N 9TH Ave
Maywood, IL 60153-1180
Phone (708) 574-8170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787788800000",
"number": "1275440885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 N 9TH AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601531180",
"telephone_number": "708-574-8170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 N 9TH AVE",
"city": "MAYWOOD",
"state": "IL",
"postal_code": "601531180",
"telephone_number": "708-574-8170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORA",
"first_name": "MARY",
"middle_name": "BETH",
"credential": "RDN, LDN, CDCES",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-08-27",
"last_updated": "2026-08-27",
"certification_date": "2026-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "IL",
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "916197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maywood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.