Individual provider Active NPI

Grazyna Gawedzki

  • Pediatric Nutrition Registered Dietitian
  • Park Ridge, IL
National Provider Identifier
1831665405
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
Practice address
829 Austin Ave
Park Ridge, IL 60068-2682
Phone
(847) 401-8714
NPI assigned
Oct 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X Primary

Addresses

Primary practice location

829 Austin Ave
Park Ridge, IL 60068-2682

Mailing address

829 Austin Ave
Park Ridge, IL 60068-2682
Phone (847) 401-8714

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

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1831665405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 AUSTIN AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682682",
            "telephone_number": "847-401-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 AUSTIN AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682682",
            "telephone_number": "847-401-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWEDZKI",
        "first_name": "GRAZYNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; 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.