Healthcare Provider Details

I. General information

NPI: 1912815390
Provider Name (Legal Business Name): JEN PRAZAK LACTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 W IRVING PARK RD APT 201
CHICAGO IL
60618-9788
US

IV. Provider business mailing address

2024 W IRVING PARK RD APT 201
CHICAGO IL
60618-9788
US

V. Phone/Fax

Practice location:
  • Phone: 630-453-7651
  • Fax: 630-453-7651
Mailing address:
  • Phone: 630-453-7651
  • Fax: 630-453-7651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER PRAZAK
Title or Position: LACTATION CONSULTANT
Credential: RN, IBCLC
Phone: 630-453-7651