Individual provider Active NPI

Amanda Marie Klimowski, MS, RD, LDN

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1518588938
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164007695 Issued in IL
Practice address
6501 S Promontory Dr # 1003
Chicago, IL 60649-1003
Phone
(773) 363-6700
NPI assigned
Apr 27, 2020
Last updated
Apr 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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 164007695 IL Primary

Addresses

Primary practice location

6501 S Promontory Dr # 1003
Chicago, IL 60649-1003

Mailing address

2537 N Wayne Ave Apt 2R
Chicago, IL 60614-8219
Phone (708) 990-6316

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aklimowski@larabida.org

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
164007695ILMDRegistered Dietitian

Interoperability endpoints

  • Direct secure messaging: aklimowski@larabida.org

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1518588938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 N WAYNE AVE APT 2R",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606148219",
            "telephone_number": "708-990-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 S PROMONTORY DR # 1003",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606491003",
            "telephone_number": "773-363-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLIMOWSKI",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164007695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aklimowski@larabida.org",
            "affiliation": "N",
            "address_1": "6501 S Promontory Dr # 1003",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606491003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Apr 27, 2020; 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.