Active NPI
Nutrition Counseling Services
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1376869883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164004712
- Legal business name
- NUTRITION COUNSELING SERVICES
- Practice address
- 410 S Michigan Ave
Ste 631
Chicago, IL 60605-1308 - Phone
- (312) 235-0050
- NPI assigned
- Apr 9, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer A Vimbor, MS, RD, LDN, CDN
- Title
- Owner
- Phone
- (312) 235-0050
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164004712 | IL | Primary |
Addresses
Primary practice location
410 S Michigan Ave
Ste 631
Chicago, IL 60605-1308
Mailing address
410 South Michigan Avenue
Suite 631
Chicago, IL 60605-1308
Phone (312) 235-0050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3122350050 | Medicaid | IL |
National Provider Directory
National Provider Directory- Tax ID family
- Nutrition Counseling Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Registered Dietitian
- Bloomingdale, IL
- NPI 1811374184
Locations
410 S Michigan Ave
Ste 631
Chicago, IL 60605
Phone (312) 235-0050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270771200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1270771200000",
"number": "1376869883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 SOUTH MICHIGAN AVENUE",
"address_2": "SUITE 631",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606051308",
"telephone_number": "312-235-0050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 S MICHIGAN AVE",
"address_2": "STE 631",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606051308",
"telephone_number": "312-235-0050"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NUTRITION COUNSELING SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2010-04-09",
"last_updated": "2010-04-09",
"status": "A",
"authorized_official_last_name": "VIMBOR",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "312-235-0050",
"authorized_official_credential": "MS, RD, LDN, CDN"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164004712",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3122350050",
"state": "IL"
}
],
"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 Apr 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.