Pathway Dietetics LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

164.001309 Issued in IL

Legal business name

PATHWAY DIETETICS LLC

Practice address

415 Machelle Dr
Cary, IL 60013-2399

Phone

(847) 354-5584

Fax

(888) 788-2497

NPI assigned

Dec 30, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Gayle O Booth, MS RD LDN CDE

Title

Owner/Registered Dietitian

Phone

(847) 354-5584

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425686400000",
    "number": "1831493162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MACHELLE DR",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600132399",
            "telephone_number": "847-354-5584",
            "fax_number": "888-788-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MACHELLE DR",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600132399",
            "telephone_number": "847-354-5584",
            "fax_number": "888-788-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAY DIETETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-30",
        "last_updated": "2015-03-07",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER/REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "847-354-5584",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS RD LDN CDE"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "164.001309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF IL DIVISION OF PROFESSIONAL REGULATION",
            "identifier": "164.001309",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Allen Palliser, D.D.S.
• Tiesha Riann Panek, PMHNP-BC
• Kenneth William Park, D.O.
• Niraj J Patel, DDS
• Rimpal N Patel
• Paul a. Palliser, D.D.S., P.C.
• Peewee Speech Therapy PLLC
• Physical Therapy Trends
• Elizabeth Rossi Pierobon, DPT
• Pioneer Center for Human Services

• Clinic/Center in Cary, IL
• Providers in Cary, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.