Active NPI
Riley Self
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1447883640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 3226 N Clark St Apt 6D
Chicago, IL 60657-1602 - Phone
- (615) 809-6393
- NPI assigned
- Feb 16, 2020
- 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 | Primary |
Addresses
Primary practice location
3226 N Clark St Apt 6D
Chicago, IL 60657-1602
Mailing address
3226 N Clark St Apt 6D
Chicago, IL 60657-1602
Phone (615) 809-6393
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581811200000",
"number": "1447883640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3226 N CLARK ST APT 6D",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606571602",
"telephone_number": "615-809-6393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3226 N CLARK ST APT 6D",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606571602",
"telephone_number": "615-809-6393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELF",
"first_name": "RILEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-16",
"last_updated": "2020-02-16",
"certification_date": "2020-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Feb 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.