Individual provider Active NPI

Anna Rosa Faso, RD, LDN

  • Registered Dietitian
  • Oak Park, IL
National Provider Identifier
1982452348
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164010279 Issued in IL
Practice address
3 Erie CT
Oak Park, IL 60302-2519
Phone
(708) 383-6200
NPI assigned
May 10, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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 164010279 IL Primary

Addresses

Primary practice location

3 Erie CT
Oak Park, IL 60302-2519

Mailing address

4930 N Austin Ave Apt 2
Chicago, IL 60630-2509
Phone (773) 503-3807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240605002516 IL Practitioner - Registered Dietitian Or Nutrition Professional 0840732822 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
164010279ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Resilience Healthcare - Lakefront Medical Associates, LLC CurrentSince May 9, 2024 Accepting new patients

Locations

4646 N Marine Dr
Chicago, IL 60640
Phone (773) 564-5102

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

7411 Lake St
Ste 1120
River Forest, IL 60305
Phone (708) 488-1490

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1982452348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 N AUSTIN AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302509",
            "telephone_number": "773-503-3807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ERIE CT",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022519",
            "telephone_number": "708-383-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASO",
        "first_name": "ANNA",
        "middle_name": "ROSA",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164010279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.