Active NPI
Andrea Peller, RDN
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1013725951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164009916
- Practice address
- 111 N Wabash Ave BLDG 3102
Chicago, IL 60602-1903 - Phone
- (234) 219-1510
- NPI assigned
- Dec 24, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164009916 | IL | Primary |
Addresses
Primary practice location
111 N Wabash Ave BLDG 3102
Chicago, IL 60602-1903
Mailing address
111 N Wabash Ave BLDG 3102
Chicago, IL 60602-1903
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164009916 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Three Meals LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734998400000",
"number": "1013725951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 N WABASH AVE BLDG 3102",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606021903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 N WABASH AVE BLDG 3102",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606021903",
"telephone_number": "234-219-1510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLER",
"first_name": "ANDREA",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-24",
"last_updated": "2024-12-24",
"certification_date": "2024-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164009916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.