Organization
DEEPLY ROOTED NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAIGE MANSO MS RD CPT CFNIP LDN (OWNER)
(708) 925-2025
Entity
Organization
Contact information
Practice address
201 WEST LAKE STREET, PMB #40731, CHICAGO, IL 60606
(708) 318-7933
Mailing address
201 WEST LAKE STREET, PMB #40731, CHICAGO, IL 60606
(708) 318-7933
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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