Individual
JACQUELYNN FALANA DOUGLAS-PETTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8205 S WINCHESTER AVE, CHICAGO, IL 60620-5340
(708) 800-9620
Mailing address
8205 S WINCHESTER AVE, CHICAGO, IL 60620-5340
(708) 800-9620
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-319753
IL
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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