Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1346843570 |
---|---|
Provider Name | Antonique Akua |
First Address | Chicago, IL 60628-1447 |
Second Address | Chicago, IL 60628-1447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2020 |
Last Update Date | 19/11/2020 |