# RISING ROOT NUTRITION LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649817768
- **Authorized official:** ERIKA KIMBERLY SIESENNOP MS, RD, LDN (DIETITIAN)
- **Authorized official phone:** (773) 241-1747

## Contact information

- **Practice address:** 2835 N SHEFFIELD AVE STE 511, CHICAGO, IL 60657-5081
- **Practice address phone:** (773) 241-1747
- **Practice address fax:** (773) 787-2181
- **Mailing address:** 2835 N SHEFFIELD AVE STE 511, CHICAGO, IL 60657-5081
- **Mailing address phone:** (773) 241-1747

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/09/2019
- **Last updated:** 12/09/2019