Active NPI
Amanda Aimee Angelopoulos, LDN, RD
- Registered Dietitian
- Park Ridge, IL
National Provider Identifier
1548744493
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164007375
- Practice address
- 826 W Touhy Ave
Park Ridge, IL 60068-3352 - Phone
- (847) 802-9826
- Fax
- (312) 648-0155
- NPI assigned
- Sep 17, 2018
- 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 | 164007375 | IL | Primary |
Addresses
Primary practice location
826 W Touhy Ave
Park Ridge, IL 60068-3352
Mailing address
826 W Touhy Ave
Park Ridge, IL 60068-3352
Phone (847) 802-9826
Other practice location 1
1699 E Woodfield Rd Ste 402
Schaumburg, IL 60173-4958
Phone (847) 868-3435
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164007375 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PHC of Buffalo Grove Clinical Psychology | Dietitian, Registered | Past | Accepting new patients |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Fitness Formula, LTD | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Vernon Hills, IL
- NPI 1235430612
Dietitian, Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716854400000",
"number": "1548744493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "826 W TOUHY AVE",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600683352",
"telephone_number": "847-802-9826",
"fax_number": "312-648-0155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "826 W TOUHY AVE",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600683352",
"telephone_number": "847-802-9826",
"fax_number": "312-648-0155"
}
],
"practiceLocations": [
{
"address_1": "1699 E Woodfield Rd Ste 402",
"address_purpose": "LOCATION",
"city": "Schaumburg",
"state": "IL",
"postal_code": "601734958",
"country_code": "US",
"telephone_number": "847-868-3435",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANGELOPOULOS",
"first_name": "AMANDA",
"middle_name": "AIMEE",
"credential": "LDN, RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-17",
"last_updated": "2024-05-28",
"certification_date": "2024-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164007375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.