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General NPI Number Information
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NPI Number | 1285426080
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Entity Type | Organization
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Legal Business Name | AIYA FUNCTIONAL WELLNESS PLLC
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 111 N WABASH AVE STE 100
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City | CHICAGO
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State | IL
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Zip | 60602-1903
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Country | US
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Telephone | 708-406-9186
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Fax |
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Provider Business Mailing Address
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Address Line | 419 EVERGREEN DR
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City | VERNON HILLS
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State | IL
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Zip | 60061-2907
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED DIETITIAN NUTRITIONIST
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Name | AIGERIM BIJELIC
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Credential | PHD, CNS, LDN
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Telephone | 708-406-9186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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