COLLEEN MICHELLE TAKAGISHI (R.D.) – Registered Dietitian, NPI 1154488344

COLLEEN MICHELLE TAKAGISHI (R.D.) is a healthcare provider. based in Evanston, Illinois. specializing in Registered Dietitian. They hold the professional credentials R.D.. They hold a License No. 164-000805 (). The NPI Number for COLLEEN MICHELLE TAKAGISHI (R.D.) is 1154488344

Main info

Female
44 Years Of Experience
Accepts Medicare Assignment
Name
COLLEEN MICHELLE TAKAGISHI (R.D.)
NPI
1154488344
Phone
(847) 570-1206
Address
2650 RIDGE AVE
Enumeration Date
3 January 2007
Last Update Date
25 February 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8479266544
Graduation Year
1982 (44 years ago)
PAC ID
0446211668
Group Practice PAC ID
2163334699
Professional Enrollment ID
I20041021000414
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for COLLEEN MICHELLE TAKAGISHI (R.D.)

  • Evanston Hospital, 2650, Ridge Avenue, Evanston, Evanston Township, Cook County, Illinois, 60201, United States

    EVANSTON HOSPITAL

    EVANSTON, IL 602011718

    Phone: (847) 570-1206

    Fax: (847) 570-1248

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-10-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20041021000414IRegistered Dietitian Or Nutrition ProfessionalILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60201)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163334699View full group profile
NameSpecialtyState
-IL
E N D O C R I N O L O G YIL
N E U R O L O G YIL
Hospitalist, Internal MedicineIL
O P H T H A L M O L O G YIL
-IL
E N D O C R I N O L O G YIL
Cardiovascular Disease (Cardiology), Interventional CardiologyIL
Clinical Social WorkerIL
Certified Nurse Midwife (Cnm)IL

Reviews

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Frequently asked questions

What NPI should I save for COLLEEN MICHELLE TAKAGISHI (R.D.)?
Save NPI 1154488344 if you need a stable reference for COLLEEN MICHELLE TAKAGISHI (R.D.).
Is COLLEEN MICHELLE TAKAGISHI (R.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is COLLEEN MICHELLE TAKAGISHI (R.D.)?
The page reflects Registered Dietitian for COLLEEN MICHELLE TAKAGISHI (R.D.). Clinical services aligned with this taxonomy classification.
Does COLLEEN MICHELLE TAKAGISHI (R.D.) practice in Illinois?
You will see Evanston, Illinois on file for COLLEEN MICHELLE TAKAGISHI (R.D.) alongside any extra practice locations.
Is COLLEEN MICHELLE TAKAGISHI (R.D.) a real provider?
This page reflects official NPPES data for NPI 1154488344. Always confirm identity and privileges with the practice and licensing boards.

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