Active NPI
Dani Pezzuto, RD, LDN
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1619708245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.008908
- Practice address
- 5815 S Maryland Ave
Chicago, IL 60637-1463 - Phone
- (773) 702-6962
- NPI assigned
- Aug 14, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.008908 | IL | Primary |
Addresses
Primary practice location
5815 S Maryland Ave
Chicago, IL 60637-1463
Mailing address
2558 W Superior St
Chicago, IL 60612-1109
Phone (857) 321-3101
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.008908 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723593600000",
"number": "1619708245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2558 W SUPERIOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606121109",
"telephone_number": "857-321-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5815 S MARYLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371463",
"telephone_number": "773-702-6962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEZZUTO",
"first_name": "DANI",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-14",
"last_updated": "2024-08-14",
"certification_date": "2024-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.008908",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.