Individual provider Active NPI

Catherine Ann Gonzalez, M.S., R.D., L.D.N.,

  • Registered Dietitian
  • Glen Ellyn, IL
National Provider Identifier
1619278736
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.001769 Issued in IL
Practice address
522 Whittier Ave
Glen Ellyn, IL 60137-4766
Phone
(630) 846-2556
NPI assigned
Nov 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164.001769 IL Primary

Addresses

Primary practice location

522 Whittier Ave
Glen Ellyn, IL 60137-4766

Mailing address

522 Whittier Ave
Glen Ellyn, IL 60137-4766
Phone (630) 846-2556

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
164.001769ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1619278736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 WHITTIER AVE",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374766",
            "telephone_number": "630-846-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 WHITTIER AVE",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601374766",
            "telephone_number": "630-846-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CATHERINE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S., R.D., L.D.N.,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.001769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2010; 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.