Active NPI
Janice M Nelson, RD
- Registered Dietitian
- Blue Island, IL
National Provider Identifier
1992930457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.001562
- Practice address
- 12935 Gregory St
Blue Island, IL 60406-2428 - Phone
- (708) 597-2000
- Fax
- (708) 824-4654
- NPI assigned
- May 27, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.001562 | IL | Primary |
Addresses
Primary practice location
12935 Gregory St
Blue Island, IL 60406-2428
Mailing address
12935 Gregory St
Blue Island, IL 60406-2428
Phone (708) 597-2000
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 |
|---|---|---|---|
| 164.001562 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243382400000",
"number": "1992930457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12935 GREGORY ST",
"city": "BLUE ISLAND",
"state": "IL",
"postal_code": "604062428",
"telephone_number": "708-597-2000",
"fax_number": "708-824-4654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12935 GREGORY ST",
"city": "BLUE ISLAND",
"state": "IL",
"postal_code": "604062428",
"telephone_number": "708-597-2000",
"fax_number": "708-824-4654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "JANICE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-27",
"last_updated": "2009-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.001562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Island, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.