Individual provider Active NPI

Anita Davila

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1497589717
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.008900 Issued in IL
Practice address
3829 N Cumberland Ave
Chicago, IL 60634-1912
Phone
(773) 216-5220
NPI assigned
Aug 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 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 164.008900 IL Primary

Addresses

Primary practice location

3829 N Cumberland Ave
Chicago, IL 60634-1912

Mailing address

3829 N Cumberland Ave
Chicago, IL 60634-1912
Phone (773) 216-5220

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
164.008900ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1497589717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3829 N CUMBERLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606341912",
            "telephone_number": "773-216-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3829 N CUMBERLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606341912",
            "telephone_number": "773-216-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "ANITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.008900",
            "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 Aug 28, 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.