NPIMap

Organization Active NPI

Nutridynamic, LLC

  • Clinic/Center
  • Palatine, IL
National Provider Identifier
1780028514
Registry record updated May 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NUTRIDYNAMIC, LLC
Practice address
675 N North CT
Suite 270
Palatine, IL 60067-8157
Phone
(847) 701-8345
NPI assigned
Apr 23, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2013

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

Authorized official

Name
Michelle Swagel, RDN, LDNNPI 1760725972
Title
Owner/Member
Phone
(847) 772-3844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

675 N North CT
Suite 270
Palatine, IL 60067-8157

Mailing address

951 Old Checker Rd
Buffalo Grove, IL 60089-1647
Phone (847) 772-3844

Other names 1

  • Pathway Nutrition Services Doing business as

National Provider Directory

National Provider Directory

Locations

675 N North Ct
Ste 270
Palatine, IL 60067
Phone (847) 701-8345

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367971200000",
    "number": "1780028514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 OLD CHECKER RD",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891647",
            "telephone_number": "847-772-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N NORTH CT",
            "address_2": "SUITE 270",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600678157",
            "telephone_number": "847-701-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRIDYNAMIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-05-08",
        "status": "A",
        "authorized_official_last_name": "SWAGEL",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "847-772-3844",
        "authorized_official_credential": "RDN, LDN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pathway Nutrition Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palatine, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.