Individual provider Active NPI

Lauren Grosskopf, MS, LDN

  • Nutritionist
  • Chicago, IL
National Provider Identifier
1609463074
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
164007588 Issued in IL
Practice address
1435 N North Park Ave Apt 3
Chicago, IL 60610-1780
Phone
(312) 834-4406
NPI assigned
Dec 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 164007588 IL Primary

Addresses

Primary practice location

1435 N North Park Ave Apt 3
Chicago, IL 60610-1780

Mailing address

1435 N North Park Ave Apt 3
Chicago, IL 60610-1780

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
164007588ILMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1609463074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 N NORTH PARK AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 N NORTH PARK AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101780",
            "telephone_number": "312-834-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSKOPF",
        "first_name": "LAUREN",
        "credential": "MS, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164007588",
            "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 Dec 30, 2020; 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.