Individual
ANGIE RUNYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., IBCLC
Contact information
Practice address
9423 HENRIETTA AVE, BROOKFIELD, IL 60513-1126
(630) 248-3372
Mailing address
9423 HENRIETTA AVE, BROOKFIELD, IL 60513-1126
(630) 248-3372
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11053511
—
Other
Enumeration date
05/28/2011
Last updated
05/28/2011
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