MEDICARE: BODY PEACE NUTRITION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1528884400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODY PEACE NUTRITION

Provider Business Mailing Address
First Line	:	5214 N WESTERN AVE STE 102
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2588
Country	:	US
Telephone Number	:	872-216-7870
Fax Number	:

Provider Business Practice Location Address
First Line	:	5214 N WESTERN AVE STE 102
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2588
Country	:	US
Telephone Number	:	872-216-7870
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN
Name	:	GIA FALBO
Credential	:	RDN, LDN
Telephone Number	:	872-216-7870

Provider Enumeration Date	:	11/25/2024
Last Update Date	:	12/15/2025

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