Amanda Wagner , MED, RDN, LDN

Dietitian, Registered • Chicago, IL

Active NPI 1053006361 Individual Practitioner Female Practitioner

Practice location in NPPES

4631 N Lincoln Ave
Chicago, IL 606252007

Call 3128849706 Location details and other listings

Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Amanda Wagner is listed in NPPES under Dietitian, Registered.
NPI assigned on April 11, 2023; this date does not establish years in practice.
No Medicare Part B / Part D records for this NPI in the CMS files shown here. CMS covers only Medicare fee-for-service / Part D claims and omits records with fewer than 11 beneficiaries, so this does not show whether the provider accepts Medicare or prescribes.

Practice Location & Contact Primary Location

Practice Address

4631 N Lincoln Ave

Chicago, IL 606252007

Telephone 3128849706

Before You Book

Paying without insurance? Prepare a cost-estimate request

Ask about interpreters and office accessibility

Organization at the Same NPPES Address or Phone

Your Kidney Dietitian Pllc Facility NPI 1336894856

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

What Public CMS Data Show

These CMS figures cover limited populations and published records; they are not quality ratings or medical advice.

Dietitian, Registered: NPPES taxonomy is a reported classification, not proof of board certification.

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Chicago and Illinois

935 active clinicians are listed under Dietitian, Registered with a practice address in Chicago, IL (2,870 in Illinois).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Chicago

3.4% of these 935 clinicians have the CMS telehealth indicator.

5.5% of these 935 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-01-09

Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Illinois Department of Financial and Professional Regulation.

Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

16 Historical Events

📍

Updated Practice Location January 09, 2026

Registered at 4631 N LINCOLN AVE, CHICAGO, IL 606252007 (Tel: 3128849706)

📍

Updated Business Mailing Address January 09, 2026

Registered at 4631 N LINCOLN AVE, CHICAGO, IL 606252007 (Tel: 3128849706)

📍

Updated Practice Location May 30, 2025

Registered at 680 N LAKE SHORE DR STE 1102629, CHICAGO, IL 606114546 (Tel: 3128849706)

📍

Updated Business Mailing Address May 30, 2025

Registered at 680 N LAKE SHORE DR STE 1102629, CHICAGO, IL 606114546 (Tel: 3128849706)

📍

Updated Practice Location June 28, 2024

Registered at 230 E OHIO ST STE 410-2629, CHICAGO, IL 606113265 (Tel: 3128849706)

📍

Updated Business Mailing Address June 28, 2024

Registered at 230 E OHIO ST STE 410-2629, CHICAGO, IL 606113265 (Tel: 3128849706)

📍

Updated Business Mailing Address September 19, 2023

Registered at 5145 N CLARK ST # 1068, CHICAGO, IL 606402829 (Tel: 3123800685)

👤

Provider Name / Credentials Updated September 19, 2023

Recorded as AMANDA WAGNER, M.ED, RDN, LDN

📍

Updated Practice Location September 06, 2023

Registered at 5145 N CLARK ST # 1068, CHICAGO, IL 606402829 (Tel: 3123800685)

👤

Provider Name / Credentials Updated September 06, 2023

Recorded as AMANDA WAGNER, M.ED, RDN

✅

NPI Profile Active April 11, 2023

NPI status registered as active in NPPES database

📍

Practice Location (Initial Record) April 11, 2023

Registered at 5228 N CAMPBELL AVE APT 3A, CHICAGO, IL 606252418 (Tel: 3123800685)

📍

Business Mailing Address (Initial Record) April 11, 2023

Registered at 5228 N CAMPBELL AVE APT 3A, CHICAGO, IL 606252418 (Tel: 3123800685)

👤

Provider Name / Credentials (Initial Record) April 11, 2023

Recorded as AMANDA WAGNER, RDN

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 11, 2023

Dietitian, Registered

🟢

Initial NPI Registration & Enumeration April 11, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1053006361

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 11, 2023

Last Update: January 09, 2026

Sole Proprietor: No

Update or Correct Profile

Other Dietitian, Registereds in Chicago

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Mailing Address

4631 N Lincoln Ave

Chicago, IL 606252007

Phone: 3128849706

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.