Individual provider Active NPI

Jessica Patel, RDN, LDN

  • Registered Dietitian
  • Downers Grove, IL
National Provider Identifier
1689117012
Registry record updated Dec 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164005887 Issued in IL
Practice address
5742 Walnut Ave
Apt 2B
Downers Grove, IL 60516-6000
Phone
(815) 603-4071
NPI assigned
Dec 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164005887 IL Primary

Addresses

Primary practice location

5742 Walnut Ave
Apt 2B
Downers Grove, IL 60516-6000

Mailing address

5742 Walnut Ave
Apt 2B
Downers Grove, IL 60516-6000
Phone (815) 603-4071

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
164005887ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1480723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480723200000",
    "number": "1689117012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5742 WALNUT AVE",
            "address_2": "APT 2B",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605166000",
            "telephone_number": "815-603-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5742 WALNUT AVE",
            "address_2": "APT 2B",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605166000",
            "telephone_number": "815-603-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "JESSICA",
        "credential": "RDN, LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-03",
        "last_updated": "2016-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164005887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2016; 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.