Rebecca Anne Ilic, RD LDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164004565 Issued in IL

Practice address

701 Winthrop Ave
Glendale Heights, IL 60139-1405

Phone

(630) 545-5655

NPI assigned

Jun 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Rebecca Anne Boehne Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1861654535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 TALBOTS LN",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600077115",
            "telephone_number": "630-292-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WINTHROP AVE",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601391405",
            "telephone_number": "630-545-5655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILIC",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "RD LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164004565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BOEHNE",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "RD LDN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Glendale Heights, IL
• Providers in Glendale Heights, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.