NPIMap

Organization Active NPI

Taylor Wolfram, LLC

  • Registered Dietitian
  • La Grange, IL
National Provider Identifier
1124619630
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
TAYLOR WOLFRAM, LLC
Practice address
421 7TH Ave
La Grange, IL 60525-6409
Phone
(312) 646-0886
NPI assigned
Jan 27, 2021
Last updated
Jan 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Taylor Wolfram, RDNPI 1205482080
Title
Owner
Phone
(815) 980-7949

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

421 7TH Ave
La Grange, IL 60525-6409

Mailing address

121 W Hillgrove Ave Unit 278
La Grange, IL 60525-1011

National Provider Directory

National Provider Directory

Locations

121 W Hillgrove Ave
Unit 278
La Grange, IL 60525

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1124619630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 W HILLGROVE AVE UNIT 278",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605251011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 7TH AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605256409",
            "telephone_number": "312-646-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR WOLFRAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "WOLFRAM",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-980-7949",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.