Individual provider · NPI-1

Ayesha Mohammad, RDN

Dietitian, Registered · Lombard, IL

NPI number1508511320
StatusActive
Last updated in NPPESFeb 21, 2022

Details

NPI
1508511320
Entity type
Individual (NPI-1)
Name
Ayesha Mohammad
Credential
RDN
Sex
Female
Sole proprietor
Yes
Enumeration date
Feb 21, 2022
Certification date
Feb 21, 2022
Last updated
Feb 21, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered164.008422ILYes

Practice location

15428 Pine View Ct.
Lombard, IL 60148

Phone 630-827-3053

Mailing address

15428 Pine View Ct.
Lombard, IL 60148

Phone 630-827-3053

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