Individual
LISA SHIRA HERRANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
5125 N KOSTNER AVE, CHICAGO, IL 60630-2608
(734) 476-0513
Mailing address
5125 N KOSTNER AVE, CHICAGO, IL 60630-2608
(734) 476-0513
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
041.361121
IL
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-45569
IL
Other
Enumeration date
04/24/2015
Last updated
04/24/2015
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