Individual
GWEN ELLEN STRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN, IBCLC
Contact information
Practice address
215 E 1ST ST STE 215, DIXON, IL 61021-3166
(815) 285-5834
Mailing address
1219 N DIXON AVE, DIXON, IL 61021-1120
(815) 285-5834
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041393780
IL
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
041393780
IL
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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