Amanda Wagner Nutrition PLLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

AMANDA WAGNER NUTRITION PLLC

Practice address

4631 N Lincoln Ave
Chicago, IL 60625-2007

Phone

(312) 884-9706

NPI assigned

Apr 23, 2024

Last updated

Jan 9, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amanda WagnerNPI 1053006361

Title

Owner and Registered Dietitian

Phone

(312) 884-9706

Specialties & licenses 1

Addresses

Other names 1

• Amanda Wagner Nutrition LLC Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Wagner, M.ED, RDN, LDN

  • Registered Dietitian
  • Chicago, IL
  • NPI 1053006361

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1992550933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252007",
            "telephone_number": "312-884-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252007",
            "telephone_number": "312-884-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDA WAGNER NUTRITION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-23",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER AND REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "312-884-9706"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amanda Wagner Nutrition LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Amanda Wagner Nutrition LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Amanda Ferrari Therapy, PLLC
• Amanda Littell
• Amanda Lucas PLLC
• Amanda Whetstone, LCSW LLC
• Amandla Charter School
• Amando a Reniva MDSC (Primary Care Skokie)
• Amani Trinity United Community Health Corporation (Synergy Counseling Center)
• Anna Alicent Amankwah

• 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 Jan 9, 2026; 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.