Provider Demographics
NPI:1013523547
Name:AL RAHAWI, DENISE (RD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:AL RAHAWI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4861 THORNBARK DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5860
Mailing Address - Country:US
Mailing Address - Phone:224-715-7523
Mailing Address - Fax:
Practice Address - Street 1:4861 THORNBARK DR
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60010-5860
Practice Address - Country:US
Practice Address - Phone:224-715-7523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164005016133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered