Healthcare Provider Details

I. General information

NPI: 1073828133
Provider Name (Legal Business Name): EDITH ERBER CD(DONA), PCD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 04/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1518 ASHLAND AVE
RIVER FOREST IL
60305-1034
US

IV. Provider business mailing address

1518 ASHLAND AVE
RIVER FOREST IL
60305-1034
US

V. Phone/Fax

Practice location:
  • Phone: 949-280-2383
  • Fax:
Mailing address:
  • Phone: 949-280-2383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: