Active NPI
McKenzie Lynn Korhorn
- Registered Dietitian
- Naperville, IL
National Provider Identifier
1295556041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164009765
- Practice address
- 24W500 Maple Ave Ste 214
Naperville, IL 60540-6057 - Phone
- (630) 474-5321
- NPI assigned
- Oct 23, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164009765 | IL | Primary |
Addresses
Primary practice location
24W500 Maple Ave Ste 214
Naperville, IL 60540-6057
Mailing address
5301 Tall Oaks CT
Plainfield, IL 60586-5754
Phone (815) 651-0584
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164009765 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nutrition Braved, LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
24W500 Maple Ave
Ste 214
Naperville, IL 60540
Phone (630) 474-5321
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1295556041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5301 TALL OAKS CT",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605865754",
"telephone_number": "815-651-0584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24W500 MAPLE AVE STE 214",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605406057",
"telephone_number": "630-474-5321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KORHORN",
"first_name": "MCKENZIE",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-23",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164009765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.