Individual provider Active NPI

Rebecca Lee Berman, M.ED, RD, CNS, CHES

  • Registered Dietitian
  • Chicago, IL
National Provider Identifier
1891130050
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164.003363 Issued in IL
Practice address
5061 North Pulaski Rd.
Chicago, IL 60630-2706
Phone
(773) 539-9364
Fax
(773) 539-0039
NPI assigned
May 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 164.003363 IL Primary

Addresses

Primary practice location

5061 North Pulaski Rd.
Chicago, IL 60630-2706

Mailing address

5601 N. Pulaski Rd.
Chicago, IL 60630-2706
Phone (773) 539-9364

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)
Enrolled
Credentials
Certified Nurse Specialist, Master of Education

State licenses

LicenseStateTypeSpecialty
164.003363ILMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1891130050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 N. PULASKI RD.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302706",
            "telephone_number": "773-539-9364",
            "fax_number": "773-539-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5061 NORTH PULASKI RD.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302706",
            "telephone_number": "773-539-9364",
            "fax_number": "773-539-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERMAN",
        "first_name": "REBECCA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "M.ED, RD, CNS, CHES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.003363",
            "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 May 1, 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.