Tara Allen, MS, RDN, LDN
Individual provider Active NPI Registered Dietitian · Olympia FLDS, IL
NPI 1285010363 · NPPES record last updated May 1, 2023
Key facts
- NPI
- 1285010363
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 164.006439 (IL)
- Practice address
- 3700 W 203Rd St Ste 310
Olympia FLDS, IL 60461-1182 - Phone
- (708) 679-2130
- Fax
- (708) 679-2260
- NPI assigned
- Jul 30, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Specialty Physicians of Illinois LLC
Practice addresses (Care Compare)
3700 W 203Rd St
Suite 310
Olympia Fields, IL 60461-1182
Phone (708) 679-2130
Hospital & facility affiliations
- Franciscan Health Olympia & Chicago Heights
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190320000880 | IL | Practitioner - Registered Dietitian Or Nutrition Professional | 9032459532 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.006439 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Specialty Physicians of Illinois, LLC | Current |
Accepting new patients | |
| Specialty Physicians of Illinois, LLC | Current |
Accepting new patients |
Locations
35318 Eagle Way
Chicago, IL 60678
17800 Kedzie Ave
Hazel Crest, IL 60429
Phone (708) 213-4200
18636 Dixie Hwy
Homewood, IL 60430
Phone (708) 647-0571
3700 W 203rd St
Ste 103
Olympia Flds, IL 60461
Phone (708) 679-2130
3700 W 203rd St
Ste 301
Olympia Flds, IL 60461
Phone (708) 679-2850
3700 W 203rd St
Ste 310
Olympia Flds, IL 60461
Phone (708) 679-2066
1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886
Interoperability endpoints
- tallen412951@direct.franciscanalliance.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.006439 | IL | Yes |
Addresses
Primary practice location
3700 W 203Rd St Ste 310
Olympia FLDS, IL 60461-1182
Mailing address
35318 Eagle Way
Chicago, IL 60678-1353
Phone (317) 528-4800
Other practice location 1
17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Phone (708) 213-3286
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tallen412951@Direct.FranciscanAlliance.org | Direct |
Other providers in Olympia FLDS, IL
All providers in Olympia FLDS, IL · Registered Dietitian in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.