Kaitlin Chakos Rodriguez, MS, RD, LDN

Individual provider Active NPI Registered Dietitian · La Grange, IL

NPI 1689313637 · NPPES record last updated May 30, 2022

Key facts

NPI
1689313637
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
164008731 (IL)
Practice address
306 S Catherine Ave
La Grange, IL 60525-6302
Phone
(630) 408-1157
NPI assigned
May 28, 2022
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
164008731ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Married to Health Single Specialty Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian
Group: 193400000X SINGLE SPECIALTY GROUP
133V00000X 164008731 IL Yes

Addresses

Primary practice location

306 S Catherine Ave
La Grange, IL 60525-6302

Mailing address

306 S Catherine Ave
La Grange, IL 60525-6302

Other providers in La Grange, IL

All providers in La Grange, IL · Registered Dietitian in Illinois

Sources for this page

Verify at the official NPI Registry.