Healthcare Provider Details

I. General information

NPI: 1457261091
Provider Name (Legal Business Name): 4TH TRIMESTER BABY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 N ORANGE AVE
CHICAGO IL
60634-2947
US

IV. Provider business mailing address

3450 N ORANGE AVE
CHICAGO IL
60634-2947
US

V. Phone/Fax

Practice location:
  • Phone: 773-234-5502
  • Fax:
Mailing address:
  • Phone: 773-234-5502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: JENNIE MEYER
Title or Position: IBCLC
Credential: IBCLC
Phone: 773-234-5502