Organization
TAYLOR WOLFRAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAYLOR WOLFRAM RD (OWNER)
(815) 980-7949
Entity
Organization
Contact information
Practice address
421 7TH AVE, LA GRANGE, IL 60525-6409
(312) 646-0886
Mailing address
121 W HILLGROVE AVE UNIT 278, LA GRANGE, IL 60525-1011
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/27/2021
Last updated
01/27/2021
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