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Organization

THIRD COAST LACTATION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH KELLY MS, RN, IBCLC (LACTATION CONSULTANT & FOUNDER)
(440) 554-9321
Entity
Organization

Contact information

Practice address
4925 N LEAVITT ST, CHICAGO, IL 60625-1308
(312) 380-9638
Mailing address
4925 N LEAVITT ST, CHICAGO, IL 60625-1308
(312) 380-9638

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
041389385
IL

Other

Enumeration date
07/30/2015
Last updated
01/19/2016
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