Healthcare Provider Details

I. General information

NPI: 1952127532
Provider Name (Legal Business Name): BLOCK AND POP LACTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2024
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 SHERIDAN RD
HIGHLAND PARK IL
60035-5356
US

IV. Provider business mailing address

303 SHERIDAN RD
HIGHLAND PARK IL
60035-5356
US

V. Phone/Fax

Practice location:
  • Phone: 847-220-4192
  • Fax: 844-294-9180
Mailing address:
  • Phone: 847-220-4192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: MELISSA BLOCK
Title or Position: OWNER
Credential: IBCLC
Phone: 847-220-4192