Active NPI
Katleya Reyes Baldazo, M.S., R.D., L.D.N
- Registered Dietitian
- Schaumburg, IL
National Provider Identifier
1457741019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164005127
- Practice address
- 999 N Plaza Dr
120
Schaumburg, IL 60173-6022 - Phone
- (773) 704-5786
- NPI assigned
- Feb 3, 2015
- 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 | 164005127 | IL | Primary |
Addresses
Primary practice location
999 N Plaza Dr
120
Schaumburg, IL 60173-6022
Mailing address
999 N Plaza Dr
120
Schaumburg, IL 60173-6022
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 |
|---|---|---|---|
| 164005127 | IL | MD | Registered Dietitian |
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": "1422921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440115200000",
"number": "1457741019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "999 N PLAZA DR",
"address_2": "120",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601736022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "999 N PLAZA DR",
"address_2": "120",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601736022",
"telephone_number": "773-704-5786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDAZO",
"first_name": "KATLEYA",
"middle_name": "REYES",
"credential": "M.S., R.D., L.D.N",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-03",
"last_updated": "2015-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164005127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Schaumburg, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.