Individual provider Active NPI

Nicole Haggerty, MS, RD, LDN

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1770148413
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164007389 Issued in IL
Practice address
355 E Erie St
Chicago, IL 60611-3167
Phone
(312) 238-1201
NPI assigned
May 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

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 164007389 IL Primary

Addresses

Primary practice location

355 E Erie St
Chicago, IL 60611-3167

Mailing address

2249 N Kedzie Blvd Apt 2
Chicago, IL 60647-2561
Phone (815) 207-1237

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
164007389ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1770148413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2249 N KEDZIE BLVD APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472561",
            "telephone_number": "815-207-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113167",
            "telephone_number": "312-238-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "NICOLE",
        "credential": "MS, RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164007389",
            "primary": true
        }
    ],
    "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 May 8, 2019; 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.