MISS KRISTA BETHANY DECEAULT (NPI# 1215446968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215446968 |
| Entity Type | Individual |
| Full Name | MISS KRISTA BETHANY DECEAULT |
| Credential | RDN |
| Practice Address |
40 Skokie Blvd Ste 200 Northbrook IL 60062-1615 |
| Mailing Address |
25002 Edison Ln Plainfield IL 60585-2240 |
| Practice Telephone | 8667291012 |
| Mailing Telephone | 3092564509 |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2017-09-26 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 86045899 | IL | Dietary & Nutritional Service Providers |
| Street Address |
40 SKOKIE BLVD STE 200 |
| City | NORTHBROOK |
| State | IL |
| Zip Code | 60062-1615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972952133 | Suncloud Health | Counselor | 40 Skokie Blvd Ste 200, Northbrook, IL 60062-1615 | 2016-06-08 |
| 1386174720 | Hannah Christian Carra | Social Worker | 40 Skokie Blvd Ste 200, Northbrook, IL 60062-1615 | 2017-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487067 | Cvs Aoc Services, L.L.C. | Optometrist | 936 Willow Road, Store 0141, Northbrook, IL 60062 | 2020-05-06 |
| 1386103885 | Jennifer Venegas | Behavior Technician | 5 Revere Dr Suit 120, Northbrook, IL 60062 | 2019-03-14 |
| 1720558281 | Taylor Hundley | Behavior Technician | 5 Revere Dr. Suite 120, Northbrook, IL 60062 | 2018-11-27 |
| 1609344027 | Melissa Cepeda | Behavior Technician | 5 Revere Dr Suite 120, Northbrook, IL 60062 | 2018-11-03 |
| 1235606658 | Candace Cheyenne Kaiser | Behavior Technician | 5 Revere Dr, Suite 120, Northbrook, IL 60062 | 2018-10-24 |
| 1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
| 1467984773 | Ayzenshteyn Chiropractic | Chiropractor | 3210 Doolittle Dr., Northbrook, IL 60062 | 2017-03-28 |
| 1396282695 | Josephine Driscoll | Physician Assistant | 400 Skokie Blvd., Suite 450, Northbrook, IL 60062 | 2017-01-24 |
| 1396297842 | Lauren Raphael Lcsw LLC | Social Worker | 3050 Pheasant Creek Drive, Apt. 104, Northbrook, IL 60062 | 2016-11-01 |
| 1851847073 | Jassim Vailoces | Physical Therapist | 634 Academy Dr, Northbrook, IL 60062 | 2016-08-28 |
| Find all providers in zip 60062 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033716113 | Ulani Villanueva | Dietitian, Registered | 470 Pfingsten Road, Northbrook, IL 60062-2506 | 2020-10-02 |
| 1821611872 | Megan Elise Barnes | Dietitian, Registered | 725 Sarah Ln, Northbrook, IL 60062-2172 | 2020-05-26 |
| 1922473909 | Meghan Mcmillin | Dietitian, Registered | 4002 Crestwood Dr, Northbrook, IL 60062-7543 | 2015-12-02 |
| 1427446327 | Jordana Wolff | Dietitian, Registered | 2445 Hampton Ln, Northbrook, IL 60062-6942 | 2014-12-30 |
| 1346360385 | Melissa Bowman Li | Dietitian, Registered | 2542 Oak Ave, Northbrook, IL 60062-5224 | 2007-03-31 |
| 1487272746 | Patricia Coleman | Dietitian, Registered | 240 Red Oak Rd, Northbrook, IL 60062-1319 | 2020-07-13 |
| 1760049415 | Libby Micaela Moser | Dietitian, Registered | 5 Revere Dr Ste 100, Northbrook, IL 60062-1567 | 2019-05-28 |
| 1578039996 | Alyson Haebig | Dietitian, Registered | 5 Revere Dr Ste 100, Northbrook, IL 60062-1567 | 2018-10-24 |
| 1912447236 | Meghan Scully | Dietitian, Registered | 5 Revere Dr, Suite 100, Northbrook, IL 60062-1566 | 2017-03-06 |
| 1801339684 | Anna Lynn Kreiser | Dietitian, Registered | 1535 Lake Cook Rd, Suite 303, Northbrook, IL 60062-1447 | 2016-11-28 |
| Find all providers in NORTHBROOK | ||||
| City | NORTHBROOK |
| Zip Code | 60062 |
Please comment or provide details below to improve the information on MISS KRISTA BETHANY DECEAULT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.