Individual provider Active NPI

Jennifer Alexis Aguirrie

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1326719113
Registry record updated Sep 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.008528 Issued in IL
Practice address
1735 W Diversey Pkwy Apt 309
Chicago, IL 60614-9386
Phone
(512) 567-2333
NPI assigned
Sep 22, 2021
Last updated
Sep 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164.008528 IL Primary

Addresses

Primary practice location

1735 W Diversey Pkwy Apt 309
Chicago, IL 60614-9386

Mailing address

1735 W Diversey Pkwy Apt 309
Chicago, IL 60614-9386
Phone (512) 567-2333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211217001989 IL Practitioner - Registered Dietitian Or Nutrition Professional 3173914553 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
164.008528ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Revolution PTWL LLC Dietitian, Registered CurrentSince Sep 21, 2021 Accepting new patients
Next Step Nutrition Counseling LLC Dietitian, Registered PastSince May 1, 2022 Accepting new patients

Locations

845 N Michigan Ave
Ste 973W
Chicago, IL 60611
Phone (312) 651-6255

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1326719113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 W DIVERSEY PKWY APT 309",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606149386",
            "telephone_number": "512-567-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 W DIVERSEY PKWY APT 309",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606149386",
            "telephone_number": "512-567-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUIRRIE",
        "first_name": "JENNIFER",
        "middle_name": "ALEXIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-22",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.008528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; 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.

Verify at the official NPI Registry.