Lawal, Taibat

Lawal, Taibat is an individual health care provider with primary practice located at 31 W 155Th St , Harvey IL 60426-3556. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Dietitian, Registered, Dietary & Nutritional Service Providers / Nutrition, Metabolic. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Lawal, Taibat can be contacted via phone (708) 596-5177.

Contact Information

Primary practice address
31 W 155Th St Harvey IL 60426-3556
Phone: (708) 596-5177
Fax: (708) 596-5518
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 164006999 Illinois
Dietary & Nutritional Service Providers / Nutrition, Metabolic 133VN1006X

Profile Details

NPI number 1740723386
LBN Legal business name Lawal, Taibat
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2016
Last updated Jun 7th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740723386 NPPES
Illinois MEDICAID 164006999

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