Active NPI
Kimberly Ann Cronin
- Registered Dietitian
- Park Ridge, IL
National Provider Identifier
1609659911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.003056
- Practice address
- 228 Albion Ave
Park Ridge, IL 60068-4912 - Phone
- (847) 894-7689
- NPI assigned
- Aug 18, 2023
- Last updated
- Aug 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | 164.003056 | IL | Primary |
Addresses
Primary practice location
228 Albion Ave
Park Ridge, IL 60068-4912
Mailing address
228 Albion Ave
Park Ridge, IL 60068-4912
Phone (847) 894-7689
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
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.003056 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | 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": "1692316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692316800000",
"number": "1609659911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 ALBION AVE",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600684912",
"telephone_number": "847-894-7689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "228 ALBION AVE",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600684912",
"telephone_number": "847-894-7689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRONIN",
"first_name": "KIMBERLY",
"middle_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-18",
"last_updated": "2023-08-18",
"certification_date": "2023-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.003056",
"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 Aug 18, 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.