Active NPI
Leslie Stiles, RD
- Pediatric Nutrition Registered Dietitian
- Chicago, IL
National Provider Identifier
1659760536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nutrition Registered Dietitian
- License
- 164.005588
- Practice address
- 3211 W George St # 3
Chicago, IL 60618-7501 - Phone
- (773) 875-5683
- NPI assigned
- Jan 15, 2015
- Last updated
- Oct 26, 2023
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 164.005588 | IL | MD | Nutritionist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Family Dietitians | Nutritionist | Current | 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.