Active NPI
Amy Gross, MPH, RD, LDN, IBCLC
- Registered Dietitian
- Lake Barrington, IL
National Provider Identifier
1376838565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.006525
- Practice address
- 28156 W Northpointe Pkwy Ste 225
Lake Barrington, IL 60010-2346 - Phone
- (224) 512-9800
- Fax
- (224) 512-9714
- NPI assigned
- Jun 15, 2011
- 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 | 164.006525 | IL | Primary |
Addresses
Primary practice location
28156 W Northpointe Pkwy Ste 225
Lake Barrington, IL 60010-2346
Mailing address
900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.006525 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
| PHC of Buffalo Grove Clinical Psychology | Dietitian, Registered | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Psychologist
- Vernon Hills, IL
- NPI 1235430612
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525305600000",
"number": "1376838565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 RAND RD STE 300",
"city": "DES PLAINES",
"state": "IL",
"postal_code": "600162359",
"telephone_number": "847-324-3976",
"fax_number": "847-929-1154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28156 W NORTHPOINTE PKWY STE 225",
"city": "LAKE BARRINGTON",
"state": "IL",
"postal_code": "600102346",
"telephone_number": "224-512-9800",
"fax_number": "224-512-9714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "AMY",
"credential": "MPH, RD, LDN, IBCLC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-15",
"last_updated": "2018-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.006525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Barrington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.