Individual provider Active NPI

Tina M Schroll, RD

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1538504154
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.002442 Issued in IL
Practice address
5061 N Pulaski Rd
Chicago, IL 60630-2706
Phone
(773) 539-0039
NPI assigned
May 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2013

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 164.002442 IL Primary

Addresses

Primary practice location

5061 N Pulaski Rd
Chicago, IL 60630-2706

Mailing address

3330 W 93Rd St
Evergreen Park, IL 60805-1544

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
164.002442ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1538504154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 W 93RD ST",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5061 N PULASKI RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302706",
            "telephone_number": "773-539-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROLL",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-09",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.002442",
            "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 May 9, 2013; 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.