Your Kidney Dietitian PLLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

YOUR KIDNEY DIETITIAN PLLC

Practice address

4631 N Lincoln Ave
Chicago, IL 60625-2007

Phone

(224) 725-3530

Fax

(312) 646-4120

NPI assigned

Feb 14, 2022

Organization subpart

No

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

Authorized official

Name

Caitlin Zalewski, RDNPI 1962838680

Title

Registered Dietitian

Phone

(224) 725-3530

Specialties & licenses 1

Addresses

Other names 1

• Your Kidney Dietitian LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Caitlin Marie Zalewski, RDN, CSR, LDN

  • Registered Dietitian
  • Chicago, IL
  • NPI 1962838680

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1336894856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252007",
            "telephone_number": "224-725-3530",
            "fax_number": "312-646-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252007",
            "telephone_number": "224-725-3530",
            "fax_number": "312-646-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR KIDNEY DIETITIAN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-14",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "ZALEWSKI",
        "authorized_official_first_name": "CAITLIN",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "224-725-3530",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Your Kidney Dietitian LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Registered Dietitian in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.