Organization
SOAK LACTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE SANTANA RN, IBCLC, CLE, CBE (OWNER)
(815) 540-3613
Entity
Organization
Contact information
Practice address
5426 MIDVALE DR UNIT A, ROCKFORD, IL 61108-2326
(815) 540-3613
Mailing address
5426 MIDVALE DR UNIT A, ROCKFORD, IL 61108-2326
(815) 540-3613
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
Other
Enumeration date
12/14/2021
Last updated
07/07/2022
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