Active NPI
Ilysha Evans
- Registered Dietitian
- Palatine, IL
National Provider Identifier
1437895059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.007200
- Practice address
- 732 W Lakeside Dr
Palatine, IL 60067-2020 - Phone
- (847) 909-0619
- NPI assigned
- May 6, 2022
- Last updated
- May 6, 2022
- 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 | 164.007200 | IL | Primary |
Addresses
Primary practice location
732 W Lakeside Dr
Palatine, IL 60067-2020
Mailing address
732 W Lakeside Dr
Palatine, IL 60067-2020
Phone (847) 909-0619
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.007200 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Well-Choices | Past | 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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651795200000",
"number": "1437895059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "732 W LAKESIDE DR",
"city": "PALATINE",
"state": "IL",
"postal_code": "600672020",
"telephone_number": "847-909-0619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "732 W LAKESIDE DR",
"city": "PALATINE",
"state": "IL",
"postal_code": "600672020",
"telephone_number": "847-909-0619"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "ILYSHA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-06",
"last_updated": "2022-05-06",
"certification_date": "2022-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.007200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palatine, IL
- European Service at Home Inc
- European Service at Home Inc
- European Service at Home Inc
- European Service at Home Inc
- European Therapy Center, LTD.
- Evolve Chiropractic Palatine PLLC
- Evolve Healing and Wellness Center
- Express Yourself Therapy
- William Scott Fager, D.C.
- Kathleen Helen Falotico, MSW, L.C.S.W.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.