Active NPI
Livia Ly
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1457739708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.006474
- Practice address
- 1212 N Lasalle St
608
Chicago, IL 60610 - Phone
- (312) 870-0150
- NPI assigned
- May 7, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 164.006474 | IL | Primary |
Addresses
Primary practice location
1212 N Lasalle St
608
Chicago, IL 60610
Mailing address
1212 N Lasalle St
608
Chicago, IL 60610
Other practice location 1
353 N Clark St
Chicago, IL 60654-4704
Phone (312) 445-5242
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 |
|---|---|---|---|
| 164.006474 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fitness Formula, LTD | 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": "1430956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566518400000",
"number": "1457739708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 N LASALLE ST",
"address_2": "608",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 N LASALLE ST",
"address_2": "608",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60610",
"telephone_number": "312-870-0150"
}
],
"practiceLocations": [
{
"address_1": "353 N Clark St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606544704",
"country_code": "US",
"telephone_number": "312-445-5242",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LY",
"first_name": "LIVIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-07",
"last_updated": "2019-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.006474",
"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 Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.