Active NPI
Jason Wong, RD, LDN
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1598468092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86065797
- Practice address
- 820 S Damen Ave
Damen 3547
Chicago, IL 60612-3728 - Phone
- (312) 752-5511
- NPI assigned
- Mar 23, 2023
- Last updated
- Mar 23, 2023
- Sex
- Male
- 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 | 86065797 | IL | Primary |
Addresses
Primary practice location
820 S Damen Ave
Damen 3547
Chicago, IL 60612-3728
Mailing address
820 South Damen Avenue
Damen 3547
Chicago, IL 60612
Phone (312) 752-5511
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 |
|---|---|---|---|
| 86065797 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679529600000",
"number": "1598468092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 SOUTH DAMEN AVENUE",
"address_2": "DAMEN 3547",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60612",
"telephone_number": "312-752-5511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 S DAMEN AVE",
"address_2": "DAMEN 3547",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123728",
"telephone_number": "312-752-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONG",
"first_name": "JASON",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-03-23",
"last_updated": "2023-03-23",
"certification_date": "2023-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "86065797",
"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 Mar 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.