Individual provider Active NPI

Ryan T Sanders, RD, LDN.

  • Registered Dietitian
  • Lake Forest, IL
National Provider Identifier
1548512221
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.005190 Issued in IL
Practice address
800 N Westmoreland Rd Ste 102
Lake Forest, IL 60045-1687
Phone
(847) 535-7647
Fax
(847) 535-8109
NPI assigned
Oct 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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 164.005190 IL Primary

Addresses

Primary practice location

800 N Westmoreland Rd Ste 102
Lake Forest, IL 60045-1687

Mailing address

1105 Oak Grove LN
Lake Forest, IL 60045-1631
Phone (847) 903-1394

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
164.005190ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1548512221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 OAK GROVE LN",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451631",
            "telephone_number": "847-903-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N WESTMORELAND RD STE 102",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451687",
            "telephone_number": "847-535-7647",
            "fax_number": "847-535-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "RYAN",
        "middle_name": "T",
        "credential": "RD, LDN.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-05",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.005190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.