Healthcare Provider Details

I. General information

NPI: 1881528453
Provider Name (Legal Business Name): JESSICA CHRISTINE STOKOWSKI RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 SW ADAMS ST
PEORIA IL
61602-1502
US

IV. Provider business mailing address

1 COBBLESTONE WAY
EUREKA IL
61530-9416
US

V. Phone/Fax

Practice location:
  • Phone: 844-381-3603
  • Fax:
Mailing address:
  • Phone: 309-287-1910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number041342470
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: