ANGELA E MACK (RD) – Registered Dietitian, NPI 1902991078

ANGELA E MACK (RD) is a healthcare provider. based in Woodstock, Illinois. specializing in REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL. They hold the professional credentials RD. They hold a License No. 1794-029 (WI). The NPI Number for ANGELA E MACK (RD) is 1902991078

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
ANGELA E MACK (RD)
NPI
1902991078
Phone
(815) 337-7100
Address
2000 LAKE AVE
Enumeration Date
4 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2622495000
Graduation Year
2004 (22 years ago)
PAC ID
1759331085
Group Practice PAC ID
6709794258
Professional Enrollment ID
I20081014000621
Address ID
WI531479694LA146XXSQXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

311 REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL in IL

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Provider Addresses for ANGELA E MACK (RD)

  • Mercy Woodstock Medical Center, 2000, Lake Avenue, Woodstock, McHenry County, Illinois, 60098, United States

    WOODSTOCK, IL 600987401

    Phone: (815) 337-7100

    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: 2008-10-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20050125000593IRegistered Dietitian Or Nutrition ProfessionalILTBD
I20081014000621IRegistered Dietitian Or Nutrition ProfessionalWITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0108Diabetes outpatient self-management training services, individual, per 30 minutes14447$0
View full utilization report →

Insurance plans in this area (ZIP 60098)

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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: 6709794258View full group profile

Reviews

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Frequently asked questions

What NPI should I save for ANGELA E MACK (RD)?
Save NPI 1902991078 if you need a stable reference for ANGELA E MACK (RD).
Is ANGELA E MACK (RD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does ANGELA E MACK (RD) treat or focus on?
Patients typically see ANGELA E MACK (RD) under the specialty Registered Dietitian. Clinical services aligned with this taxonomy classification.
What location metadata exists for ANGELA E MACK (RD)?
The page summarizes Woodstock, Illinois for ANGELA E MACK (RD); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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