Individual provider Active NPI

Kristin Ann Leicht, R.D.

  • Registered Dietitian
  • Oak Park, IL
National Provider Identifier
1992897607
Registry record updated Nov 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
164004100 Issued in IL
Practice address
1048 Lake Street, Suite 300
Oak Park, IL 60301-1102
Phone
(630) 606-2587
NPI assigned
Sep 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2014

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 164004100 IL Primary

Addresses

Primary practice location

1048 Lake Street, Suite 300
Oak Park, IL 60301-1102

Mailing address

1048 Lake Street, Suite 300
Oak Park, IL 60301-1102

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415750400000",
    "number": "1992897607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 LAKE STREET, SUITE 300",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 LAKE STREET, SUITE 300",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011102",
            "telephone_number": "630-606-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHT",
        "first_name": "KRISTIN",
        "middle_name": "ANN",
        "credential": "R.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2014-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164004100",
            "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 Nov 12, 2014; 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.