Active NPI
Lisa Carroll, MS, RD, LDN
- Registered Dietitian
- Naperville, IL
National Provider Identifier
1417456955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.005331
- Practice address
- 525 S Washington St
Naperville, IL 60540-6749 - Phone
- (630) 926-5472
- NPI assigned
- Feb 11, 2018
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 164.005331 | IL | Primary |
Addresses
Primary practice location
525 S Washington St
Naperville, IL 60540-6749
Mailing address
1406 N Greenview Ave Unit 1
Chicago, IL 60642-2352
Phone (630) 926-5472
Other practice location 1
218 N Jefferson St
Chicago, IL 60661-1121
Phone (630) 926-5472
Other practice location 2
210 W Maple St
New Lenox, IL 60451-1774
Phone (630) 926-5472
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.005331 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lotus Therapy Group Inc | Dietitian, Registered | Current | Accepting new patients |
Organizations & group practices 1
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": "1518307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1417456955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 N GREENVIEW AVE UNIT 1",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606422352",
"telephone_number": "630-926-5472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 S WASHINGTON ST",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605406749",
"telephone_number": "630-926-5472"
}
],
"practiceLocations": [
{
"address_1": "218 N Jefferson St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606611121",
"country_code": "US",
"telephone_number": "630-926-5472",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "210 W Maple St",
"address_purpose": "LOCATION",
"city": "New Lenox",
"state": "IL",
"postal_code": "604511774",
"country_code": "US",
"telephone_number": "630-926-5472",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARROLL",
"first_name": "LISA",
"credential": "MS, RD, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-11",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.005331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.