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AMANDA WAGNER M.ED, RDN, LDN
NPI 1053006361
Dietitian, Registered in Chicago, IL

Active since April 11, 2023
4631 N LINCOLN AVE, CHICAGO, IL 60625(312) 884-9706 Get Directions Write a Review

NPPES record last updated: January 9, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jan 9, 2026, May 30, 2025, Jun 28, 2024 and 2 more (5 updates tracked since 2023).

About Amanda Wagner M.ed, Rdn, Ldn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA WAGNER M.ED, RDN, LDN (NPI 1053006361) is an individual dietitian, registered in Chicago, Illinois and active in the NPI registry since April 2023.

NPPES Registry Identity

NPI1053006361
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameAMANDA WAGNERCredential: M.ED, RDN, LDN
Location Address4631 N LINCOLN AVEChicago, IL 60625-2007
Mailing Address4631 N Lincoln AveChicago, IL 60625-2007 · (312) 884-9706
Phone(312) 884-9706
Sole ProprietorNo
Enumeration DateApril 11, 2023
Last NPPES UpdateJanuary 9, 20265 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2026
✔ NPI 1053006361 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Definition
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.
4631 N LINCOLN AVE, Chicago, IL 60625
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Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YOUR KIDNEY DIETITIAN PLLC
Dietitian, Registered
4631 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (224) 725-3530
LONETTE GEORGE
Counselor (Professional)
4631 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (872) 888-2557
THE DIETITIAN RX
Dietitian, Registered
4631 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (773) 231-8130
AMANDA WAGNER NUTRITION PLLC
Dietitian, Registered
4631 N LINCOLN AVE
CHICAGO, IL 60625
Cook County (312) 884-9706

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amanda Wagner's NPI number?

The NPI number for Amanda Wagner is 1053006361. It was assigned to this individual provider in the NPPES registry on April 11, 2023.

Where is Amanda Wagner located?

Amanda Wagner practices at 4631 N Lincoln Ave, Chicago, IL 60625. The listed phone number is (312) 884-9706.

What is Amanda Wagner's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

When was this NPI record last updated?

The NPPES record for Amanda Wagner was last updated on January 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.