Individual provider Active NPI

Raquel Robles, RDN, LDN

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Willowbrook, IL
National Provider Identifier
1619308608
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X
Practice address
6200 Bentley Ave
Willowbrook, IL 60527-1963
Phone
(708) 691-2382
Fax
(224) 220-5064
NPI assigned
Dec 2, 2013
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education Nutritionist 133NN1002X 164.005838 IL
Registered Dietitian 133V00000X 164.005838 IL
Registered Dietitian 133V00000X 2024034004 MO
Renal Nutrition Registered Dietitian 133VN1005X 164.005838 IL
Pediatric Nutrition Registered Dietitian 133VN1004X 164.005838 IL
Metabolic Nutrition Registered Dietitian 133VN1006X 164.005838 IL
Gerontological Nutrition Registered Dietitian 133VN1101X 164.005838 IL
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X 164.005838 IL
Oncology Nutrition Registered Dietitian 133VN1301X 164.005838 IL
Sports Dietetics Nutrition Registered Dietitian 133VN1501X 164.005838 IL
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X 164.005838 IL
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X Primary

Addresses

Primary practice location

6200 Bentley Ave
Willowbrook, IL 60527-1963

Mailing address

6200 Bentley Ave
Willowbrook, IL 60527-1963
Phone (708) 691-2382

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190219000639 IL Practitioner - Registered Dietitian Or Nutrition Professional 5294073136 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6200 Bentley Ave
Willowbrook, IL 60527-1963
Phone (708) 691-2382

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
164.005838ILMDRegistered Dietitian
2024034004MOMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Dietitians at Home Inc Dietitian, Registered CurrentSince Jan 14, 2019 Accepting new patients
Optimum Health and Nutrition, Inc Past Accepting new patients

Locations

2003 W Fulton St
Ste 105
Chicago, IL 60612
Phone (312) 850-3437

Organizations & group practices 3

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": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1619308608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 BENTLEY AVE",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605271963",
            "telephone_number": "708-691-2382",
            "fax_number": "224-220-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 BENTLEY AVE",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605271963",
            "telephone_number": "708-691-2382",
            "fax_number": "224-220-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBLES",
        "first_name": "RAQUEL",
        "name_prefix": "Ms.",
        "credential": "RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "IL",
            "license": "164.005838",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.005838",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MO",
            "license": "2024034004",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "IL",
            "license": "164.005838",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "IL",
            "license": "164.005838",
            "primary": false
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "IL",
            "license": "164.005838",
            "primary": false
        },
        {
            "code": "133VN1101X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Gerontological",
            "state": "IL",
            "license": "164.005838",
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "IL",
            "license": "164.005838",
            "primary": false
        },
        {
            "code": "133VN1301X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": "IL",
            "license": "164.005838",
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "IL",
            "license": "164.005838",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164.005838",
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.