Individual
GREGORY TABAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-8387
Mailing address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-8387
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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