Active NPI
Amelia Sage Venetos, RD
- Registered Dietitian
- Crystal Lake, IL
National Provider Identifier
1477315364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.009593
- Practice address
- 760 McArdle Dr Ste B
Crystal Lake, IL 60014-8149 - Phone
- (312) 771-7501
- NPI assigned
- Jan 25, 2024
- Last updated
- Sep 23, 2026
- 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 | 164.009593 | IL | Primary |
Addresses
Primary practice location
760 McArdle Dr Ste B
Crystal Lake, IL 60014-8149
Mailing address
2551 N Clark St Ste 200
Chicago, IL 60614-1798
Phone (312) 771-7501
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 |
|---|---|---|---|
| 164.009593 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790121600000",
"number": "1477315364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2551 N CLARK ST STE 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606141798",
"telephone_number": "312-771-7501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 MCARDLE DR STE B",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600148149",
"telephone_number": "312-771-7501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENETOS",
"first_name": "AMELIA",
"middle_name": "SAGE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-25",
"last_updated": "2026-09-23",
"certification_date": "2026-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.009593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.