Active NPI
Georgia Blaha, RD
- Registered Dietitian
- Chicago, IL
National Provider Identifier
1558374652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 1525 W Homer St
Ste 301
Chicago, IL 60622-1280 - Phone
- (773) 292-1940
- Fax
- (773) 292-1939
- NPI assigned
- Aug 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 | IL | Primary |
Addresses
Primary practice location
1525 W Homer St
Ste 301
Chicago, IL 60622-1280
Mailing address
8148 Clarendon Hills Rd
Willowbrook, IL 60527-2689
Phone (708) 951-6736
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.000667 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chicagoland Ad Medical Inc | 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.
-
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1063647329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1558374652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8148 CLARENDON HILLS RD",
"city": "WILLOWBROOK",
"state": "IL",
"postal_code": "605272689",
"telephone_number": "708-951-6736",
"fax_number": "630-654-8527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 W HOMER ST",
"address_2": "STE 301",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606221280",
"telephone_number": "773-292-1940",
"fax_number": "773-292-1939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAHA",
"first_name": "GEORGIA",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": null,
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.