Chicago Nutrition Clinic LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

CHICAGO NUTRITION CLINIC LLC

Practice address

625 W Adams St # 20-144
Chicago, IL 60661-3603

Phone

(847) 609-9101

NPI assigned

Mar 17, 2021

Organization subpart

No

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

Authorized official

Name

Amanda Sheaffer, MS RDN LDN

Title

Ceo/ RDN

Phone

(847) 609-9101

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1922683341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 W ADAMS ST UNIT 375",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W ADAMS ST # 20-144",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606613603",
            "telephone_number": "847-609-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO NUTRITION CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "SHEAFFER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CEO/ RDN",
        "authorized_official_telephone_number": "847-609-9101",
        "authorized_official_credential": "MS RDN LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://chicagonutritionclinic.com/",
            "affiliation": "N",
            "address_1": "625 W Adams St # 20-144",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606613603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• 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 Mar 17, 2021; 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.