Peggy Balboa, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164.005248 Issued in IL

Practice address

4646 N Marine Dr
Suite a-4600
Chicago, IL 60640-5759

Phone

(773) 564-7400

Fax

(773) 564-7401

NPI assigned

Aug 15, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: peggy.balboa.1@13465.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1154875516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 S DRYDEN PL",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052137",
            "telephone_number": "847-830-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 N MARINE DR",
            "address_2": "SUITE A-4600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405759",
            "telephone_number": "773-564-7400",
            "fax_number": "773-564-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALBOA",
        "first_name": "PEGGY",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164.005248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Kirit Balatero, MSN, RN, CNL
• Ahleah Balawender, PA-C
• Ali Balay, LCSW
• Lara Elaine Balay, CGC
• Lourenz Marie Balayan
• Erika Balbuena
• Leonel Antonio Balcarcel
• Cesar A Balcazar
• Katie Anne Balcer, P.A.
• Jakub Balcerzak, PHARM. D.

• Registered Dietitian in Chicago, IL
• Providers in Chicago, IL by specialty
• Registered Dietitian in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.