NPIMap

Organization Active NPI

Beloved Community Family Wellness Ctr

  • Registered Dietetic Technician
  • Chicago, IL
National Provider Identifier
1891123832
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Dietetic TechnicianTaxonomy code 136A00000X
License
86034476 Issued in IL
Legal business name
BELOVED COMMUNITY FAMILY WELLNESS CTR
Practice address
6821 S Halsted St
Chicago, IL 60621-1833
Phone
(773) 651-3629
Fax
(773) 322-1599
NPI assigned
Oct 30, 2013
Last updated
Oct 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Authorized official

Name
Ms. Assenath Naaman, LDN
Title
Dietician
Phone
(773) 651-3629

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietetic TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 136A00000X 86034476 IL Primary

Addresses

Primary practice location

6821 S Halsted St
Chicago, IL 60621-1833

Mailing address

6821 S Halsted Street
Chicago, IL 60621
Phone (773) 651-3629

National Provider Directory

National Provider Directory
Tax ID family
Beloved Community Family Wellness Ctr5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383091200000",
    "number": "1891123832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6821 S HALSTED STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60621",
            "telephone_number": "773-651-3629",
            "fax_number": "773-322-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6821 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606211833",
            "telephone_number": "773-651-3629",
            "fax_number": "773-322-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELOVED COMMUNITY FAMILY WELLNESS CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-30",
        "last_updated": "2013-10-30",
        "status": "A",
        "authorized_official_last_name": "NAAMAN",
        "authorized_official_first_name": "ASSENATH",
        "authorized_official_title_or_position": "DIETICIAN",
        "authorized_official_telephone_number": "773-651-3629",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LDN"
    },
    "taxonomies": [
        {
            "code": "136A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietetic Technician, Registered",
            "state": "IL",
            "license": "86034476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.