Individual
TIFFANY LAUREN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
922 W DIVERSEY PKWY, CHICAGO, IL 60614-1416
(773) 529-0057
Mailing address
1150 W 15TH ST UNIT 302, CHICAGO, IL 60608-3688
(708) 262-2169
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.007666
IL
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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