Active NPI
Victoria Reynoso
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1508520461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.008431
- Practice address
- 737 N Michigan Ave Ste 1925
Chicago, IL 60611-5422 - Phone
- (312) 283-2650
- NPI assigned
- Oct 27, 2021
- 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 | 164.008431 | IL | Primary |
Addresses
Primary practice location
737 N Michigan Ave Ste 1925
Chicago, IL 60611-5422
Mailing address
1260 N Dearborn St Apt 1204
Chicago, IL 60610-2244
Phone (949) 705-8674
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 |
|---|---|---|---|
| 164.008431 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1508520461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1260 N DEARBORN ST APT 1204",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606102244",
"telephone_number": "949-705-8674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "737 N MICHIGAN AVE STE 1925",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606115422",
"telephone_number": "312-283-2650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOSO",
"first_name": "VICTORIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-27",
"last_updated": "2021-10-27",
"certification_date": "2021-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.008431",
"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 Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.