Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063406569 Individual Practitioner Male Practitioner

Dr. Richenel Samuel Ellecom , PsyD, DRPH

Dietitian, Registered • Willow Brook, IL

Professional Overview & Biography Verified Profile Summary

Dr. Richenel Ellecom, PsyD, DRPH is a registered healthcare professional specializing in Dietitian, Registered in Willow Brook, IL. Practice services are available at 621 PLAINFIELD RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

621 Plainfield Rd
Suite 110

Willow Brook, IL 605275343

Telephone 6306541377
Fax 6306542575
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Willow Brook, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.7 Yrs
Regional Practice Density
1 Specialists

Practicing in Willow Brook, IL (2895 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License IL 164-2611

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.

Clinical Neuropsychologist

NUCC Taxonomy Code: 103G00000X

State License IL 71-5240

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Clinical Neuropsychologist

NUCC Taxonomy Code: 103G00000X

State License IN 20040961A

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
200909210A (IN)
Medicaid State Provider ID
200078600 (IN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Patrick Gordon , PsyD

Psychologist - Clinical

NPI 1679703680

Doctor of Psychology (Psy.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 27, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location October 27, 2008

Registered at 621 PLAINFIELD RD, SUITE 110, WILLOW BROOK, IL 605275343 (Tel: 6306541377)

📍
Updated Business Mailing Address October 27, 2008

Registered at 621 PLAINFIELD RD, SUITE 110, WILLOW BROOK, IL 605275343 (Tel: 6306541377)

👤
Provider Name / Credentials Updated October 27, 2008

Recorded as RICHENEL ELLECOM, PSY.D; DR.P.H

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 27, 2008

Clinical Neuropsychologist (License #20040961A in IN)

🟢
Initial NPI Registration & Enumeration September 12, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Richenel Ellecom. Be the first to share your experience!

Sign in to leave a review for Dr. Richenel Ellecom

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1063406569
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 12, 2005
Last Update: October 27, 2008
Sole Proprietor: Yes

Mailing Address

621 Plainfield Rd, Suite 110

Willow Brook, IL 605275343

Phone: 6306541377

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.