Active NPI
Raquel Robles, RDN, LDN
- Obesity and Weight Management Nutrition Registered Dietitian
- Willowbrook, IL
National Provider Identifier
1619308608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity and Weight Management Nutrition Registered Dietitian
- 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, 2024
- 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 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 | |
| Nutritionist | 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 164.005838 | IL | MD | Registered Dietitian |
| 2024034004 | MO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dietitians at Home Inc | Dietitian, Registered | Current | 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.
-
- Registered Dietitian
- Palos Hills, IL
- NPI 1083245575
-
- Exclusive Provider Organization
- Hickory Hills, IL
- NPI 1619390671
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.