Organization
TLN PROFESSIONAL SERVICES II, PC
Active
Organization
TLN PROFESSIONAL SERVICES II, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INSIYAH GOMBERAWALLA MD (PRESIDENT & SECRETARY)
(708) 872-7653
Entity
Organization
Contact information
Practice address
702 E SOUTH TEMPLE STE 102, SALT LAKE CITY, UT 84102-1487
(888) 510-0059
Mailing address
1621 W CARROLL AVE, CHICAGO, IL 60612-2501
(888) 510-0059
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
—
—
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
07/16/2025
Last updated
10/01/2025
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