Mrs Kelly Wynne Minarick, RD, RDN, LDN in Lisle, IL - Medicare Dietitian, Registered Provider

Mrs Kelly Wynne Minarick, RD, RDN, LDN is a medicare enrolled "Dietitian, Registered" provider in Lisle, Illinois. Her current practice location is 650 Warrenville Rd Ste 100, Lisle, Illinois. You can reach out to her office (for appointments etc.) via phone at (847) 318-3013.

Mrs Kelly Wynne Minarick is licensed to practice in Illinois (license number 164.007272) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1073251724.

Contact Information

	Mrs Kelly Wynne Minarick, RD, RDN, LDN
	650 Warrenville Rd Ste 100, Lisle, IL 60532-4315
	(847) 318-3013
	(833) 290-5413

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Kelly Wynne Minarick
Gender	Female
Speciality	Dietitian, Registered
Location	650 Warrenville Rd Ste 100, Lisle, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073251724
Provider Enumeration Date: 05/23/2022
Last Update Date: 03/21/2024

Medicare PECOS Information:

PECOS PAC ID: 9335586783
Enrollment ID: I20240321001982

Medical Identifiers

Medical identifiers for Mrs Kelly Wynne Minarick such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073251724	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
133V00000X	Dietitian, Registered	164.007272 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Kelly Wynne Minarick allows following entities to bill medicare on her behalf.

Provider Name	Doherty Nutrition Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1326502832 PECOS PAC ID: 0941610273 Enrollment ID: O20240321001684

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kelly Wynne Minarick is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Kelly Wynne Minarick, RD, RDN, LDN 17060 Dallas Pkwy Ste 112, Dallas, TX 75248-1905 Ph: (469) 372-2022	Mrs Kelly Wynne Minarick, RD, RDN, LDN 650 Warrenville Rd Ste 100, Lisle, IL 60532-4315 Ph: (847) 318-3013

Reviews and Comments

Dietitian, Registered in Lisle, IL

Jennifer Westerkamp, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 701 Warrenville Rd Ste 210, Lisle, IL 60532 Phone: 312-664-3456 Fax: 312-588-7255
Dupagedietitians Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3080 Ogden Ave, 104, Lisle, IL 60532 Phone: 630-839-9296 Fax: 630-364-1873
Mrs. Deepa Deshmukh, MPH,RD,LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3080 Ogden Ave, Lisle, IL 60532 Phone: 630-839-9296
Emma Cone, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 701 Warrenville Rd Ste 210, Lisle, IL 60532 Phone: 312-664-3456
Kianna Cook, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 701 Warrenville Road, Suite 210, Lisle, IL 60532 Phone: 919-268-2363
Marina Kassandra Hale, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 5900 Oakwood Dr Apt 1k, Lisle, IL 60532 Phone: 818-378-2583

Mrs Kelly Wynne Minarick, RD, RDN, LDN - Medicare Dietitian in Lisle, IL