Optimum Health and Nutrition, Inc

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

164.005838 Issued in IL

Legal business name

OPTIMUM HEALTH AND NUTRITION, INC

Practice address

8805 S 82ND Ave
Hickory Hills, IL 60457-1444

Phone

(708) 527-0772

NPI assigned

Jan 28, 2014

Organization subpart

No

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

Authorized official

Name

Raquel Lopez, RDN, LDN

Title

President/ Registered Dietitian

Phone

(708) 527-0772

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raquel Robles, RDN, LDN

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Willowbrook, IL
  • NPI 1619308608
  NPD (past)

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1619390671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8805 S 82ND AVE",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "604571444",
            "telephone_number": "708-527-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8805 S 82ND AVE",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "604571444",
            "telephone_number": "708-527-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM HEALTH AND NUTRITION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "RAQUEL",
        "authorized_official_title_or_position": "PRESIDENT/ REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "708-527-0772",
        "authorized_official_credential": "RDN, LDN"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "IL",
            "license": "164.005838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI TYPE I LISTED BELOW",
            "identifier": "1619308608",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNA",
            "identifier": "0670",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED DIETITIAN NUTRITIONIST LICENSE NUMBER",
            "identifier": "164.005838",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Toyin Myrick
• Kim Neumann
• Abby Leigh Nieves, MSPT
• North Palos School Dist 117
• Matthew C Okon, CPO
• Vincent Marie Palabrica-Sorongon, PT, DPT
• Samiya Papa, PHARMD
• Avani Ajay Patel, NP
• PDP Medical Solutions, LLC
• Leona Dalia Petreikis, DDS

• Exclusive Provider Organization in Hickory Hills, IL
• Providers in Hickory Hills, IL by specialty
• Exclusive Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.