Active NPI
Suzanne Linda Delrose, RDN
- Registered Dietitian
- Homewood, IL
National Provider Identifier
1639795065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164001353
- Practice address
- 940 Maple Rd
Homewood, IL 60430-2061 - Phone
- (708) 799-0244
- NPI assigned
- Jun 22, 2020
- 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 | 164001353 | IL | Primary |
Addresses
Primary practice location
940 Maple Rd
Homewood, IL 60430-2061
Mailing address
826 Belot LN
New Lenox, IL 60451-9258
Phone (815) 474-4718
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 |
|---|---|---|---|
| 164001353 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592784000000",
"number": "1639795065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "826 BELOT LN",
"city": "NEW LENOX",
"state": "IL",
"postal_code": "604519258",
"telephone_number": "815-474-4718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "940 MAPLE RD",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604302061",
"telephone_number": "708-799-0244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELROSE",
"first_name": "SUZANNE",
"middle_name": "LINDA",
"name_prefix": "Mrs.",
"credential": "RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-22",
"last_updated": "2020-06-22",
"certification_date": "2020-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164001353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.