Live Your Best You 365, Inc

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

164004502 Issued in IL

Legal business name

LIVE YOUR BEST YOU 365, INC

Practice address

1020 Milwaukee Ave
341
Deerfield, IL 60015-3513

Phone

(847) 478-8477

NPI assigned

Sep 20, 2012

Organization subpart

No

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

Authorized official

Name

Alisa Bloom, MPH, RDN, LDN

Title

Sole Proprietor

Phone

(847) 748-8477

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1528319316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 CASTLEWOOD LN",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600153971",
            "telephone_number": "773-951-5557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 MILWAUKEE AVE",
            "address_2": "341",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600153513",
            "telephone_number": "847-478-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE YOUR BEST YOU 365, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "ALISA",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "847-748-8477",
        "authorized_official_credential": "MPH, RDN, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164004502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "164004502",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.