Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1245574433 |
---|---|
Provider Name | Ms. Kelly Sviatko |
First Address | Mundelein, IL 60060-1835 |
Second Address | Mundelein, IL 60060-1835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2012 |
Last Update Date | 06/02/2013 |