Maria Bournas, RDN,LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.005027 Issued in IL

Practice address

400 Farrington Dr
Lincolnshire, IL 60069-2502

Phone

(847) 571-7816

NPI assigned

Jan 11, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Maria Provias Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1508637240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 FARRINGTON DR",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600692502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 FARRINGTON DR",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600692502",
            "telephone_number": "847-571-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNAS",
        "first_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "RDN,LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.005027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "PROVIAS",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katie Bennett
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• Sandra Nicole Blondin, BCBA
• Luke Bohlin
• Bethany Bowkett
• Carolyn Brady, PT
• Dolores Imroth Braun, LCPC
• Kristen Britton
• Barbara Bugner, RN

• Registered Dietitian in Lincolnshire, IL
• Providers in Lincolnshire, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.