Active NPI
Reanna Peterman, MS, RDN, LDN
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1467942631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164007360
- Practice address
- 1440 W Taylor St # 359
Chicago, IL 60607-4623 - Phone
- (815) 409-8501
- NPI assigned
- May 14, 2018
- Last updated
- Mar 19, 2025
- 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 | 164007360 | IL | Primary |
Addresses
Primary practice location
1440 W Taylor St # 359
Chicago, IL 60607-4623
Mailing address
1440 W Taylor St # 359
Chicago, IL 60607-4623
Phone (815) 409-8501
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164007360 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rebel Nutrition PLLC | Dietitian, Registered | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742342400000",
"number": "1467942631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 W TAYLOR ST # 359",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606074623",
"telephone_number": "815-409-8501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1440 W TAYLOR ST # 359",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606074623",
"telephone_number": "815-409-8501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERMAN",
"first_name": "REANNA",
"credential": "MS, RDN, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-14",
"last_updated": "2025-03-19",
"certification_date": "2025-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164007360",
"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 Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.