Active NPI
Stephanie Bucz, RD
- Registered Dietitian
- Elmhurst, IL
National Provider Identifier
1770058877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.009074
- Practice address
- 1200 S York St
Elmhurst, IL 60126-5626 - Phone
- (331) 221-6140
- NPI assigned
- Oct 4, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 8890 | FL | |
| Registered Dietitian | 133V00000X | 164.009074 | IL | Primary |
Addresses
Primary practice location
1200 S York St
Elmhurst, IL 60126-5626
Mailing address
1200 S York St
Elmhurst, IL 60126-5626
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164.009074 | Other | IL | STATE LICENSE |
| 8890 | Other | FL | STATE LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8890 | FL | MD | Registered Dietitian |
| 164.009074 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allara Medical Group PA | 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 and National Provider Directory roles.
-
- Gynecology Physician
- New York, NY
- NPI 1700450558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678665600000",
"number": "1770058877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 S YORK ST",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601265626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 S YORK ST",
"city": "ELMHURST",
"state": "IL",
"postal_code": "601265626",
"telephone_number": "331-221-6140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUCZ",
"first_name": "STEPHANIE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-04",
"last_updated": "2023-03-13",
"certification_date": "2023-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "8890",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.009074",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "164.009074",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "8890",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.