Active NPI
Haileiy Nicole Tylisz, RD
- Registered Dietitian
- Barrington, IL
National Provider Identifier
1699521849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86117814
- Practice address
- 1531 S Grove Ave
Barrington, IL 60010-5240 - Phone
- (817) 205-1622
- NPI assigned
- Apr 29, 2024
- Last updated
- Apr 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 86117814 | TN | Primary |
Addresses
Primary practice location
1531 S Grove Ave
Barrington, IL 60010-5240
Mailing address
21 Kristin Dr Unit 813
Schaumburg, IL 60195-3336
Phone (219) 877-4875
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 |
|---|---|---|---|
| 86117814 | TN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Olive Branch Nutrition LLC | Dietitian, Registered | Past | Accepting new patients |
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": "1714348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714348800000",
"number": "1699521849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 KRISTIN DR UNIT 813",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601953336",
"telephone_number": "219-877-4875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1531 S GROVE AVE",
"city": "BARRINGTON",
"state": "IL",
"postal_code": "600105240",
"telephone_number": "817-205-1622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYLISZ",
"first_name": "HAILEIY",
"middle_name": "NICOLE",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-29",
"last_updated": "2024-04-29",
"certification_date": "2024-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TN",
"license": "86117814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barrington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.