Individual provider Active NPI

Marla Cohn Solomon, RD, LD/N, CDE

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1578620753
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164000305 Issued in IL
Practice address
840 S Wood St
Chicago, IL 60612-4325
Phone
(312) 996-1795
Fax
(312) 996-8218
NPI assigned
Jan 3, 2007
Last updated
May 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X 164-000305 IL
Registered Dietitian 133V00000X 164000305 IL Primary

Addresses

Primary practice location

840 S Wood St
Chicago, IL 60612-4325

Mailing address

571 Orchard Lane
Winnetka, IL 60093-4145
Phone (847) 501-5170

Other identifiers 1

IdentifierTypeStateIssuer
164-000305OtherILIL STATE LIC

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

LicenseStateTypeSpecialty
164-000305ILMDNutrition Education Nutritionist
164000305ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1578620753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 ORCHARD LANE",
            "city": "WINNETKA",
            "state": "IL",
            "postal_code": "600934145",
            "telephone_number": "847-501-5170",
            "fax_number": "847-784-8392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-1795",
            "fax_number": "312-996-8218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "MARLA",
        "middle_name": "COHN",
        "name_prefix": "Ms.",
        "credential": "RD, LD/N, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "IL",
            "license": "164-000305",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164000305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE LIC",
            "identifier": "164-000305",
            "state": "IL"
        }
    ],
    "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 4, 2012; 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.