Active NPI
Scott Michael Nygren, RD, LND
- Registered Dietitian
- North Chicago, IL
National Provider Identifier
1992095459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164000288
- Practice address
- 3001 Green Bay Rd
North Chicago, IL 60064-3048 - Phone
- (224) 610-5330
- Fax
- (224) 610-3847
- NPI assigned
- Apr 18, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 | 164000288 | IL | Primary |
Addresses
Primary practice location
3001 Green Bay Rd
North Chicago, IL 60064-3048
Mailing address
2043 Ironwood CT
Gurnee, IL 60031-1795
Phone (847) 263-0617
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 |
|---|---|---|---|
| 164000288 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303084800000",
"number": "1992095459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2043 IRONWOOD CT",
"city": "GURNEE",
"state": "IL",
"postal_code": "600311795",
"telephone_number": "847-263-0617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 GREEN BAY RD",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "600643048",
"telephone_number": "224-610-5330",
"fax_number": "224-610-3847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NYGREN",
"first_name": "SCOTT",
"middle_name": "MICHAEL",
"credential": "RD, LND",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-18",
"last_updated": "2011-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164000288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.