Provider Demographics
NPI:1013546241
Name:ROMAN, ASIYAH (RD, LDN)
Entity Type:Individual
Prefix:
First Name:ASIYAH
Middle Name:
Last Name:ROMAN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 BARRINGTON RD STE 400
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2036
Mailing Address - Country:US
Mailing Address - Phone:630-808-6004
Mailing Address - Fax:
Practice Address - Street 1:2300 N BARRINGTON RD STE 400
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2036
Practice Address - Country:US
Practice Address - Phone:630-808-6004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164004208133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered