Elevated Soul Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

ELEVATED SOUL NUTRITION LLC

Practice address

4332 W Madison St
Chicago, IL 60624-2223

Phone

(773) 217-8177

NPI assigned

Feb 27, 2024

Last updated

Apr 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Sharony L Brown, RD, CDCES

Title

Ceo

Phone

(773) 217-8177

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712361600000",
    "number": "1659137594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4332 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606242223",
            "telephone_number": "773-217-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4332 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606242223",
            "telephone_number": "773-217-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATED SOUL NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-04-06",
        "certification_date": "2024-04-06",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "SHARONY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-217-8177",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RD, CDCES"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Apr 6, 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.

Verify at the official NPI Registry.