Provider Demographics
NPI:1972224533
Name:NABILA'S NUTRITION
Entity type:Organization
Organization Name:NABILA'S NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NABILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCORDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-697-6913
Mailing Address - Street 1:PO BOX 2664
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-1093
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18210 LA GRANGE RD STE 201
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-7725
Practice Address - Country:US
Practice Address - Phone:815-277-1158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty