Organization
ICONIC NURSE NETWORK OUTREACH, INC
Active
Organization
ICONIC NURSE NETWORK OUTREACH, INC
Active
Other names
Iconic Health Academy
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LAKHILA TELLIS RN, CHW (FOUNDER/PRESIDENT)
(312) 468-8604
Entity
Organization
Contact information
Practice address
730 N CHURCH ST # LL-3, ROCKFORD, IL 61103-6917
(312) 931-7376
Mailing address
730 N CHURCH ST # LL-3, ROCKFORD, IL 61103-6917
(312) 931-7376
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
163WW0000X
Wound Care Registered Nurse
—
—
172V00000X
Community Health Worker
Primary
—
—
251B00000X
Case Management Agency
—
—
364SC1501X
Community Health/Public Health Clinical Nurse Specialist
—
—
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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