Active NPI
Kathryn Brown, RDN, LDN
- Registered Dietitian
- Round Lake, IL
National Provider Identifier
1962874297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.006550
- Practice address
- 325 W Caldwell Dr
Round Lake, IL 60073-4294 - Phone
- (847) 609-6654
- NPI assigned
- Oct 26, 2015
- Last updated
- Jul 11, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86012436 | IL | |
| Registered Dietitian | 133V00000X | 164.006550 | IL | Primary |
Addresses
Primary practice location
325 W Caldwell Dr
Round Lake, IL 60073-4294
Mailing address
325 W Caldwell Dr
Round Lake, IL 60073-4294
Phone (847) 609-6654
Other practice location 1
1500 Robin Cir
Apt 314
Hoffman Estates, IL 60169-1152
Phone (847) 609-6654
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 |
|---|---|---|---|
| 164.006550 | IL | MD | Registered Dietitian |
| 86012436 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1962874297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 W CALDWELL DR",
"city": "ROUND LAKE",
"state": "IL",
"postal_code": "600734294",
"telephone_number": "847-609-6654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 W CALDWELL DR",
"city": "ROUND LAKE",
"state": "IL",
"postal_code": "600734294",
"telephone_number": "847-609-6654"
}
],
"practiceLocations": [
{
"address_1": "1500 Robin Cir",
"address_2": "Apt 314",
"address_purpose": "LOCATION",
"city": "Hoffman Estates",
"state": "IL",
"postal_code": "601691152",
"country_code": "US",
"telephone_number": "847-609-6654",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROWN",
"first_name": "KATHRYN",
"credential": "RDN, LDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-26",
"last_updated": "2024-07-11",
"certification_date": "2024-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "86012436",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.006550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Round Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.