Real Foods Collective

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

REAL FOODS COLLECTIVE

Practice address

815 Lexington St
Maywood, IL 60153-3245

Phone

(708) 574-8170

NPI assigned

Feb 24, 2025

Organization subpart

No

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

Authorized official

Name

Mary Beth Mora, MS, RDN, LDN, CDCES

Title

Executive Director

Phone

(708) 574-8170

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1609672104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 N 3RD AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601531118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 LEXINGTON ST",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533245",
            "telephone_number": "708-574-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAL FOODS COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "MORA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-574-8170",
        "authorized_official_credential": "MS, RDN, LDN, CDCES"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Maywood, IL
• Providers in Maywood, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.