Provider Demographics
NPI:1730856527
Name:FOOD WONDERFUL
Entity type:Organization
Organization Name:FOOD WONDERFUL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FIORENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, LDN
Authorized Official - Phone:312-985-7141
Mailing Address - Street 1:815 W VAN BUREN ST STE 330
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3568
Mailing Address - Country:US
Mailing Address - Phone:312-985-7141
Mailing Address - Fax:312-453-0676
Practice Address - Street 1:815 W VAN BUREN ST STE 330
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3568
Practice Address - Country:US
Practice Address - Phone:312-985-7141
Practice Address - Fax:312-453-0676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-27
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty