Nicholas S Palumbo, R.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164005341 Issued in IL

Practice address

2003 W Fulton St
Suite 105
Chicago, IL 60612-2345

Phone

(312) 850-3438

Fax

(312) 638-9872

NPI assigned

Sep 29, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ad Medical Supply, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1629015904

  Dietitian, Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1861701500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 W FULTON ST",
            "address_2": "SUITE 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122345",
            "telephone_number": "312-850-3438",
            "fax_number": "312-638-9872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 W FULTON ST",
            "address_2": "SUITE 105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122345",
            "telephone_number": "312-850-3438",
            "fax_number": "312-638-9872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Sherman Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602022815",
            "country_code": "US",
            "telephone_number": "224-900-7562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALUMBO",
        "first_name": "NICHOLAS",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-29",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164005341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "248002576",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "164005341",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Samuel Palter, M.D.
• Allison Marie Paltzer, MS
• Elizabeth Paluch
• Linda Anne Palumbo, M.D.
• Michael Palumbo, PHD
• Nicole Palumbo, M.A., BCBA
• Simy Paluvelil Mathew, DMD, BDS
• Pam Eernisse DPM SC
• Pam Eernisse DPM SC
• Pamela E Smith MD MPH Ches SC

• Registered Dietitian in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.