DR. BONNIE LYNN BROCK (NPI# 1285171504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285171504 |
| Entity Type | Individual |
| Full Name | DR. BONNIE LYNN BROCK |
| Credential | MPH, RD, LDN, ND |
| Practice Address |
708 Church St Evanston IL 60201 |
| Mailing Address |
1420 W Hutchinson St Apt 3n Chicago IL 60613-1343 |
| Practice Telephone | 8479030503 |
| Mailing Telephone | 7733311740 |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2020-10-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | 164006979 | IL | Dietary & Nutritional Service Providers |
| N | 175F00000X | Naturopath | 20-1917 | AZ | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1124 Lake St, 503, Oak Park, IL 603011382 | 7733311740 |
| Street Address |
708 CHURCH ST |
| City | EVANSTON |
| State | IL |
| Zip Code | 60201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942295738 | Mary C Hagele | Psychologist | 708 Church St, Suite 251, Evanston, IL 60201-3875 | 2005-09-16 |
| 1043857691 | Sara E P Solheim | Social Worker | 708 Church St, Evanston, IL 60201-3875 | 2019-12-03 |
| 1104306240 | A New Leaf Natural Medicine LLC | Dietitian, Registered | 708 Church St, Evanston, IL 60201-3875 | 2018-08-17 |
| 1346603156 | Evanston Integrative Chiropractic Center | Chiropractor | 708 Church St, Ste. 228, Evanston, IL 60201-3875 | 2016-03-30 |
| 1386009009 | Ashley Allis LLC | Counselor | 708 Church St, Suite 221, Evanston, IL 60201-3875 | 2015-12-22 |
| 1720453160 | John Koh | Psychologist | 708 Church St, Suite 216, Evanston, IL 60201-3875 | 2015-12-10 |
| 1770951022 | Alison Rachel Toback | Counselor | 708 Church St, Suite #206, Evanston, IL 60201-3875 | 2015-09-03 |
| 1780050591 | Joseph Alger | Social Worker | 708 Church St, Suite 225, Evanston, IL 60201-3875 | 2015-08-16 |
| 1669871133 | Ashley Allis | Counselor | 708 Church St, Suite 221, Evanston, IL 60201-3875 | 2014-08-20 |
| 1124449012 | Frances R. Schnadig, Lcsw, LLC | Social Worker | 708 Church St, Suite 233, Evanston, IL 60201-3875 | 2013-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962898 | Sebastian Andres Cruz | Internal Medicine | Northshore University Healthsystem, Off of Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2020-05-06 |
| 1053970442 | Wade Gilman | Family Medicine | 1650 Ridge Ave, Ste 1304, Evanston, IL 60201 | 2019-06-10 |
| 1922577949 | Elizabeth Wilton Therapy, LLC | Counselor | 2901a Central St Ste 3, Evanston, IL 60201 | 2018-11-20 |
| 1952887812 | Sg Wellness LLC | Clinic/Center | 3008 Central Street, Evanston, IL 60201 | 2018-07-13 |
| 1689169591 | Michael Kert Zijlstra | Internal Medicine | Northshore University Healthsystem Office of Academic, Affairs 2650 Ridge Ave, Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1982199725 | Elizabeth Hannah Lees | Internal Medicine | Northshore University Healthsystem Office of Academic A, 2650 Ridge Ave Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1730674565 | Ashley Elizabeth Aller | Internal Medicine | Northshore University Healthsystem, Office Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1669967683 | Ayush N Shah | Internal Medicine | 2650 Ridge Ave Ste 5315, Evanston, IL 60201 | 2018-06-22 |
| 1811481062 | Jeffrey D. Brow | Internal Medicine | 2650 Ridge Ave Rm 5315, Evanston, IL 60201 | 2018-06-20 |
| 1831687250 | Michael Patrick Murphy | Radiology | 807 Davis St. Unit 707, Evanston, IL 60201 | 2018-05-01 |
| Find all providers in zip 60201 | ||||
| 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 |
|---|---|---|---|---|
| 1053941112 | Lakeside Digestion Pllc | Dietitian, Registered | 501 Sherman Ave, Evanston, IL 60202-2815 | 2020-01-16 |
| 1073150678 | Allison Wall | Dietitian, Registered | 1011 Ashland Ave Fl 2, Evanston, IL 60202-1138 | 2019-12-03 |
| 1215376918 | An Apple A Day Nutrition, Inc. | Dietitian, Registered | 1324 1/2 Forest Ave, Evanston, IL 60201-4791 | 2013-06-17 |
| 1770784027 | Suzanne Elizabeth Leland-lym | Dietitian, Registered | 25 Pleasant View St, Evanston, WY 82930-9510 | 2007-05-31 |
| 1821207663 | Uchenna Genevieve Ohajunwa | Dietitian, Registered | Evanston Northwestern Healthcare, 2650 Ridge Avenue, Evanston, IL 60201 | 2007-05-21 |
| 1033242136 | Merle Rose Shapera | Dietitian, Registered | 1572 Maple Avenue, Unit 604, Evanston, IL 60201 | 2007-03-14 |
| 1245305804 | Bridges Habilitation Services Inc. | Dietitian, Registered | 100 Bear River Dr, Evanston, WY 82930-2804 | 2006-11-21 |
| 1760081673 | Lauren Elizabeth Todorova | Dietitian, Registered | 2650 Ridge Ave, Evanston, IL 60201-1700 | 2020-10-21 |
| 1861000994 | Alisa Oler | Dietitian, Registered | 9437 Harding Ave, Evanston, IL 60203-1322 | 2020-07-15 |
| 1295375343 | Kelsey Bencze | Dietitian, Registered | 2255 Campus Dr, Evanston, IL 60201 | 2020-01-07 |
| Find all providers in EVANSTON | ||||
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| 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.