Individual provider Active NPI

Lori Granich, RDN

  • Registered Dietitian
  • New Lenox, IL
National Provider Identifier
1457775371
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1005436 Issued in IL
Practice address
1941 Grand Prairie Dr
New Lenox, IL 60451-3561
Phone
(773) 848-3651
NPI assigned
Feb 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1005436 IL Primary

Addresses

Primary practice location

1941 Grand Prairie Dr
New Lenox, IL 60451-3561

Mailing address

13421 S Avenue L
Chicago, IL 60633-1521
Phone (773) 848-3651

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

LicenseStateTypeSpecialty
1005436ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1457775371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13421 S AVENUE L",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606331521",
            "telephone_number": "773-848-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 GRAND PRAIRIE DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513561",
            "telephone_number": "773-848-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANICH",
        "first_name": "LORI",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-12",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "1005436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.