Healthcare Provider Details

I. General information

NPI: 1720334402
Provider Name (Legal Business Name): PATRICIA ZILLWEGER KUEHN MSN, RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 HERMITAGE DR
DEERFIELD IL
60015-4445
US

IV. Provider business mailing address

534 HERMITAGE DR
DEERFIELD IL
60015-4445
US

V. Phone/Fax

Practice location:
  • Phone: 630-743-1919
  • Fax:
Mailing address:
  • Phone: 630-743-1919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-104579
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: