Active NPI
Jennifer Jeanne Sherman, RDN
- Registered Dietitian
- Oak Park, IL
National Provider Identifier
1306365937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.007185
- Practice address
- 1048 Lake St Ste 300
Oak Park, IL 60301-1072 - Phone
- (708) 383-0258
- NPI assigned
- Sep 14, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.007185 | IL | Primary |
Addresses
Primary practice location
1048 Lake St Ste 300
Oak Park, IL 60301-1072
Mailing address
6253 N Sheridan Rd Apt 25
Chicago, IL 60660-5728
Phone (773) 573-4839
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.007185 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emerge Physical Therapy & Wellness PLLC | Current | Accepting new patients | |
| Revolution PTWL LLC | Dietitian, Registered | Current | Accepting new patients |
| Ageoptions Inc. | Past | Accepting new patients | |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Locations
845 N Michigan Ave
Ste 973W
Chicago, IL 60611
Phone (312) 651-6255
1962 N Bissell St
Ste 1
Chicago, IL 60614
Phone (312) 598-9991
Organizations & group practices 4
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.
-
- Physical Therapist
- Chicago, IL
- NPI 1679105142
-
dba Revolution Physical Therapy Weight Loss
- Physical Therapist
- Chicago, IL
- NPI 1164766606
Dietitian, Registered
-
- Voluntary or Charitable Agency
- Oak Park, IL
- NPI 1609222041
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505347200000",
"number": "1306365937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6253 N SHERIDAN RD APT 25",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606605728",
"telephone_number": "773-573-4839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1048 LAKE ST STE 300",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603011072",
"telephone_number": "708-383-0258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERMAN",
"first_name": "JENNIFER",
"middle_name": "JEANNE",
"name_prefix": "Ms.",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-14",
"last_updated": "2017-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.007185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; 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.