Diane Martinez Dadivas, RD

Primary specialty

Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X

License

164.005298 Issued in IL

Practice address

8439 N Clifton Ave
Niles, IL 60714-1803

Phone

(281) 901-8481

Fax

(833) 271-4447

NPI assigned

Aug 11, 2010

Last updated

Jun 12, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pediatric Education Dietitian Services

  • Home Health Agency
  • Ellisville, MO
  • NPI 1598862724
  NPD (past)

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1790090033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8439 N CLIFTON AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141803",
            "telephone_number": "281-901-8481",
            "fax_number": "833-271-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8439 N CLIFTON AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607141803",
            "telephone_number": "281-901-8481",
            "fax_number": "833-271-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADIVAS",
        "first_name": "DIANE",
        "middle_name": "MARTINEZ",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "IL",
            "license": "164.005298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creative Therapy Resource, LLC (FYZICAL Therapy and Balance Center)
• Curepath Health Physician Partners PLLC
• James B Curley
• Bozena Teresa Czerska, OTR
• D2 Dental of Lansing, P.C.
• Jesus Rene Dadivas Jr., M.D.
• Mona Fe Kendi Dagani, RPT
• Joseph Daniels, ED.D
• Robin David, MD
• Trudi Davis, LCSW

• Pediatric Nutrition Registered Dietitian in Niles, IL
• Providers in Niles, IL by specialty
• Pediatric Nutrition Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.