Active NPI
Theresa Christine Denk, MNT
- Registered Dietitian
- Berwyn, IL
National Provider Identifier
1548205974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 3249 Oak Park Ave
Dietary Dept
Berwyn, IL 60402-3429 - Phone
- (708) 783-3076
- NPI assigned
- Jun 19, 2006
- Sex
- Female
- Sole proprietor
- No
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 | IL | Primary |
Addresses
Primary practice location
3249 Oak Park Ave
Dietary Dept
Berwyn, IL 60402-3429
Mailing address
2368 Paysphere Cir
Chicago, IL 60674-0023
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 |
|---|---|---|---|
| 164-003750 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192406400000",
"number": "1548205974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2368 PAYSPHERE CIR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606740023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3249 OAK PARK AVE",
"address_2": "DIETARY DEPT",
"city": "BERWYN",
"state": "IL",
"postal_code": "604023429",
"telephone_number": "708-783-3076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENK",
"first_name": "THERESA",
"middle_name": "CHRISTINE",
"credential": "MNT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-19",
"last_updated": "2007-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.