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Individual

HILARY SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BS, IBCLC

Contact information

Practice address
2112 25TH AVE, ROCK ISLAND, IL 61201-5317
(309) 558-2880
(309) 794-7091
Mailing address
2112 25TH AVE, ROCK ISLAND, IL 61201-5317
(309) 558-2880
(309) 794-7091

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
174N00000X
Lactation Consultant (Non-RN)
Primary
L-107074
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005
IL
Enumeration date
01/23/2025
Last updated
01/23/2025
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