Healthcare Provider Details

I. General information

NPI: 1275300089
Provider Name (Legal Business Name): ZAINAB TAIWO DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N WABASH AVE STE 100
CHICAGO IL
60602-1903
US

IV. Provider business mailing address

111 N WABASH AVE STE 100
CHICAGO IL
60602-1903
US

V. Phone/Fax

Practice location:
  • Phone: 224-408-0589
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277004901
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: