NPIMap

Organization Active NPI

Mynutritiongoals.Com LLC

  • Early Intervention Provider Agency
  • Northfield, IL
National Provider Identifier
1306205760
Registry record updated Feb 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
878730 Issued in IL
Legal business name
MYNUTRITIONGOALS.COM LLC
Practice address
288 Dickens St
Northfield, IL 60093-3225
Phone
(773) 354-4944
Fax
(844) 692-0008
NPI assigned
Feb 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2016

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

Authorized official

Name
Amy ManojlovskiNPI 1598962425
Title
Owner/Dietitian
Phone
(773) 354-4944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 878730 IL Primary

Addresses

Primary practice location

288 Dickens St
Northfield, IL 60093-3225

Mailing address

288 Dickens St
Northfield, IL 60093-3225
Phone (773) 354-4944

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455408000000",
    "number": "1306205760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "288 DICKENS ST",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933225",
            "telephone_number": "773-354-4944",
            "fax_number": "844-692-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "288 DICKENS ST",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600933225",
            "telephone_number": "773-354-4944",
            "fax_number": "844-692-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYNUTRITIONGOALS.COM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-14",
        "last_updated": "2016-02-14",
        "status": "A",
        "authorized_official_last_name": "MANOJLOVSKI",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OWNER/DIETITIAN",
        "authorized_official_telephone_number": "773-354-4944"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "IL",
            "license": "878730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2016; 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.