MEDICARE: DR. ZAINAB TAIWO DNP, PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	277004901	IL

General Provider Information

NPI Number	:	1275300089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZAINAB TAIWO DNP, PMHNP-BC

Provider Business Mailing Address
First Line	:	111 N WABASH AVE STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-1903
Country	:	US
Telephone Number	:
Fax Number	:	279-300-4163

Provider Business Practice Location Address
First Line	:	111 N WABASH AVE STE 100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60602-1903
Country	:	US
Telephone Number	:	224-408-0589
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2023
Last Update Date	:	04/15/2026

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