NPIMap

Organization Active NPI

Illinois Dietitians, LLC

  • Registered Dietitian
  • Oak Park, IL
National Provider Identifier
1487085791
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.004823 Issued in IL
Legal business name
ILLINOIS DIETITIANS, LLC
Practice address
715 Lake St. , Suite 220
Oak Park, IL 60301-1411
Phone
(708) 285-1347
Fax
(708) 356-6611
NPI assigned
Dec 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Ms. Eileen H McCarthy, RDNPI 1265673958
Title
Owner, Rd
Phone
(708) 285-1347

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X 164.004823 IL Primary

Addresses

Primary practice location

715 Lake St. , Suite 220
Oak Park, IL 60301-1411

Mailing address

PO Box 4004
Oak Park, IL 60303-4004
Phone (708) 285-1347

Other names 1

  • Midwest Dietitians Other name

National Provider Directory

National Provider Directory
Tax ID family
Illinois Dietitians LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

715 Lake St
Ste 220
Oak Park, IL 60301
Phone (708) 285-1347

Practitioners & affiliated clinicians

Practitioners 1

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": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1487085791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4004",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603034004",
            "telephone_number": "708-285-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 LAKE ST. , SUITE 220",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011411",
            "telephone_number": "708-285-1347",
            "fax_number": "708-356-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DIETITIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER, RD",
        "authorized_official_telephone_number": "708-285-1347",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.004823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Dietitians",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.