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Individual

MRS. KENDRA L SHELBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1425 SHERBORN CT S, MINOOKA, IL 60447-4569
(815) 557-6792
Mailing address
1425 SHERBORN CT S, MINOOKA, IL 60447-4569
(815) 557-6792

Taxonomy

Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-82571
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
S510-5128-2895
DRIVER ID
IL
Enumeration date
03/04/2022
Last updated
03/04/2022
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