Active NPI
Taibat Lawal
- Registered Dietitian
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164006999
- Practice address
- 1801 W Taylor St
Chicago, IL 60612-4795 - Phone
- (312) 413-3631
- NPI assigned
- Nov 30, 2016
- Last updated
- Oct 31, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164006999 | IL | Primary |
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 164006999 | IL |
Addresses
Primary practice location
1801 W Taylor St
Chicago, IL 60612-4795
Mailing address
1801 W Taylor St
Chicago, IL 60612-4795
Other practice location 1
19767 Torrence Ave
Lynwood, IL 60411-7624
Phone (708) 596-5177
Other practice location 2
7250 S Dorchester Ave
Chicago, IL 60619-1543
Phone (312) 550-4635
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164006999 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164006999 | IL | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients |
Locations
1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700
7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210
845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
dba Occupational Health Service Institute (OHSI)
- Occupational Medicine Physician
- Chicago, IL
- NPI 1043727571
-
- Neurology Physician
- Chicago, IL
- NPI 1982824660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761868800000",
"number": "1740723386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 W TAYLOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 W TAYLOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124795",
"telephone_number": "312-413-3631"
}
],
"practiceLocations": [
{
"address_1": "19767 Torrence Ave",
"address_purpose": "LOCATION",
"city": "Lynwood",
"state": "IL",
"postal_code": "604117624",
"country_code": "US",
"telephone_number": "708-596-5177",
"fax_number": "708-596-5518",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7250 S Dorchester Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606191543",
"country_code": "US",
"telephone_number": "312-550-4635",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LAWAL",
"first_name": "TAIBAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-30",
"last_updated": "2025-10-31",
"certification_date": "2025-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164006999",
"primary": true
},
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "IL",
"license": "164006999",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "164006999",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.