Individual provider Active NPI

Leslie Stiles, RD

  • Pediatric Nutrition Registered Dietitian
  • Chicago, IL
National Provider Identifier
1659760536
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
164.005588 Issued in IL
Practice address
3211 W George St # 3
Chicago, IL 60618-7501
Phone
(773) 875-5683
NPI assigned
Jan 15, 2015
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 164.005588 IL
Nutrition Education Nutritionist 133NN1002X 164.005588 IL
Registered Dietitian 133V00000X 164.005588 IL
Pediatric Nutrition Registered Dietitian 133VN1004X 164.005588 IL Primary
Metabolic Nutrition Registered Dietitian 133VN1006X 164.005588 IL

Addresses

Primary practice location

3211 W George St # 3
Chicago, IL 60618-7501

Mailing address

3511 Madison Ave
Brookfield, IL 60513-1234

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

LicenseStateTypeSpecialty
164.005588ILMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Dietitians Nutritionist CurrentSince Oct 29, 2023 Accepting new patients

Locations

5600 Wolf Rd
Ste 135
Western Springs, IL 60558
Phone (708) 246-4515

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, 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": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1659760536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 MADISON AVE",
            "city": "BROOKFIELD",
            "state": "IL",
            "postal_code": "605131234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 W GEORGE ST # 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606187501",
            "telephone_number": "773-875-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILES",
        "first_name": "LESLIE",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164.005588",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "IL",
            "license": "164.005588",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.005588",
            "primary": false
        },
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "IL",
            "license": "164.005588",
            "primary": true
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "IL",
            "license": "164.005588",
            "primary": false
        }
    ],
    "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 Oct 26, 2023; 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.