Active NPI
Desiree N Lavin, RD
- Registered Dietitian
- Frankfort, IL
National Provider Identifier
1902013188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.004666
- Practice address
- 10309 W Lincoln Hwy
Frankfort, IL 60423-1280 - Phone
- (309) 370-3751
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.004666 | IL | Primary |
Addresses
Primary practice location
10309 W Lincoln Hwy
Frankfort, IL 60423-1280
Mailing address
8534 Stone Creek Blvd
Frankfort, IL 60423-9338
Phone (309) 370-3751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164.004666 | Other | IL | STATE LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.004666 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712275200000",
"number": "1902013188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8534 STONE CREEK BLVD",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604239338",
"telephone_number": "309-370-3751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10309 W LINCOLN HWY",
"city": "FRANKFORT",
"state": "IL",
"postal_code": "604231280",
"telephone_number": "309-370-3751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVIN",
"first_name": "DESIREE",
"middle_name": "N",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2024-04-05",
"certification_date": "2024-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.004666",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "164.004666",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frankfort, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.