MEDICARE: ASHLEY LAKIN NUTRITION LLC

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	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1659033579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHLEY LAKIN NUTRITION LLC

Provider Business Mailing Address
First Line	:	137 N OAK PARK AVE STE 215
Second Line	:
City	:	OAK PARK
State	:	IL
Zip	:	60301-1340
Country	:	US
Telephone Number	:	847-261-4693
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 GLENDALE LN
Second Line	:
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169-3233
Country	:	US
Telephone Number	:	847-261-4693
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL INTEGRATIVE NUTRITIONIST
Name	:	ASHLEY LAKIN
Credential	:	MS, CNS, LDN
Telephone Number	:	847-261-4693

Provider Enumeration Date	:	10/07/2021
Last Update Date	:	04/27/2026

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