NPIMap

Organization Active NPI

Olive Branch Nutrition LLC

  • Registered Dietitian
  • Huntley, IL
National Provider Identifier
1467051912
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
OLIVE BRANCH NUTRITION LLC
Practice address
9654 Kelley LN
Huntley, IL 60142-0058
Phone
(630) 750-0955
NPI assigned
Oct 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Authorized official

Name
Efthemia Greco, RD, LDN
Title
Owner
Phone
(630) 750-0955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

9654 Kelley LN
Huntley, IL 60142-0058

Mailing address

9654 Kelley LN
Huntley, IL 60142-0058
Phone (630) 750-0955

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://olivebranchnutrition.clientsecure.me/ Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

760 McArdle Dr
Ste B
Crystal Lake, IL 60014
Phone (312) 771-7501

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1467051912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9654 KELLEY LN",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601420058",
            "telephone_number": "630-750-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9654 KELLEY LN",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601420058",
            "telephone_number": "630-750-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-25",
        "last_updated": "2024-05-01",
        "certification_date": "2024-04-24",
        "status": "A",
        "authorized_official_last_name": "GRECO",
        "authorized_official_first_name": "EFTHEMIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-750-0955",
        "authorized_official_credential": "RD, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://olivebranchnutrition.clientsecure.me/",
            "affiliation": "N",
            "endpointDescription": "Simple Practice Client Portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Client Portal",
            "address_1": "9654 Kelley Ln",
            "city": "Huntley",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601420058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntley, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.