Michel D Harris, R.D., LDN, CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164003376 Issued in IL

Practice address

3523 N Lincoln Ave
Chicago, IL 60657-1137

Phone

(773) 929-6262

NPI assigned

Aug 19, 2006

Last updated

Mar 19, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Miss Michel D. Di Vito Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Heritage Healthcare Group LLC

  • Health Service Clinic/Center
  • Chicago, IL
  • NPI 1386995058
  NPD (past)
• Heritage Healthcare Group, LLC

  • Registered Dietitian
  • Milwaukee, WI
  • NPI 1225392046

  Dietitian, Registered

  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1427162056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4356 N KENMORE AVE",
            "address_2": "APT 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131330",
            "telephone_number": "312-550-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3523 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571137",
            "telephone_number": "773-929-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MICHEL",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "R.D., LDN, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164003376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED DIETITIAN NUTRITIONIST",
            "identifier": "164.003376",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED DIABETES EDUCATOR",
            "identifier": "20120370",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "46-5085580",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHEL",
            "last_name": "DI VITO",
            "middle_name": "D.",
            "prefix": "MISS",
            "credential": "RD, LDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew B Harris
• Mauriah Harris
• Megan Harris, DNP
• Meghan Marie Harris, APRN
• Michael Kenneth Harris Jr.
• Mitchell M Harris, L.AC, DIPL OM
• Najila Tanisha Harris, LPC
• Nina Marie Harris
• Paul Vivian Harris, PSY.D.
• Quinn Erica Harris

• 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 Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.