Active NPI
Roberta Helen Clarke Jenero, LDN
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1780061762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164001957
- Practice address
- 980 N Michigan Ave
Suite 1400
Chicago, IL 60611-4501 - Phone
- (312) 988-4850
- Fax
- (847) 430-3108
- NPI assigned
- Apr 29, 2015
- 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 | 164001957 | IL | Primary |
Addresses
Primary practice location
980 N Michigan Ave
Suite 1400
Chicago, IL 60611-4501
Mailing address
925 N Prospect Ave
Park Ridge, IL 60068-2668
Phone (847) 508-7536
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548498777 | Other | IL | NPPES |
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 |
|---|---|---|---|
| 164001957 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430265600000",
"number": "1780061762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 N PROSPECT AVE",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600682668",
"telephone_number": "847-508-7536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "980 N MICHIGAN AVE",
"address_2": "SUITE 1400",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606114501",
"telephone_number": "312-988-4850",
"fax_number": "847-430-3108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENERO",
"first_name": "ROBERTA",
"middle_name": "HELEN CLARKE",
"name_prefix": "Mrs.",
"credential": "LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-29",
"last_updated": "2015-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164001957",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPPES",
"identifier": "1548498777",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
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- Jenin Dental Corp.
- Natasha Tamika Jenkins Cooper, M.D.
- Sharon E. Jenkins-Collins, D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.