Provider Demographics
NPI:1972856581
Name:NUTRIWORLD INC.
Entity Type:Organization
Organization Name:NUTRIWORLD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PURA
Authorized Official - Middle Name:ALEGRIA
Authorized Official - Last Name:YARRA
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:708-485-3422
Mailing Address - Street 1:3453 GRAND BLVD.
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60513-1207
Mailing Address - Country:US
Mailing Address - Phone:708-485-3422
Mailing Address - Fax:708-485-3142
Practice Address - Street 1:3453 GRAND BLVD.
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:IL
Practice Address - Zip Code:60513-1207
Practice Address - Country:US
Practice Address - Phone:708-485-3422
Practice Address - Fax:708-485-3142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL372359133V00000X
IL00009260332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332U00000XSuppliersHome Delivered Meals
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty