Lori Bumbaco, MS, RDN, CSO, LDN

Primary specialty

Oncology Nutrition Registered DietitianTaxonomy code 133VN1301X

License

164.006161 Issued in IL

Practice address

610 Onwentsia Ave
Highland Park, IL 60035-2030

Phone

(201) 787-2220

NPI assigned

May 1, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1801062633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 ONWENTSIA AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352030",
            "telephone_number": "201-787-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 ONWENTSIA AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352030",
            "telephone_number": "201-787-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUMBACO",
        "first_name": "LORI",
        "credential": "MS, RDN, CSO, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "IL",
            "license": "943720",
            "primary": false
        },
        {
            "code": "133VN1301X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1301X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": "IL",
            "license": "164.006161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorie Brottman
• Marchele Brown
• Francis Alan Bugaj, DDS
• Srdja Bulatovic, MD
• Bulbul Bahuguna
• Betty Burke, SLP
• Polina Burshteyn, PT, DPT
• Jacqueline Paige Cabrera, FNP-BC
• Patricia R/ Cahalan, PT
• Julie Friend Cairo, MS, CCC-SLP

• Registered Dietitian in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.