Individual
TARA JEANINE OLIVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, MS, RD, LDN
Contact information
Practice address
12023 S 71ST CT, PALOS HEIGHTS, IL 60463-1542
(708) 207-4224
Mailing address
12023 S 71ST CT, PALOS HEIGHTS, IL 60463-1542
(708) 207-4224
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005727
IL
Other
Enumeration date
10/20/2012
Last updated
10/20/2012
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