Healthcare Provider Details

I. General information

NPI: 1285329664
Provider Name (Legal Business Name): TELELACT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 HAUSER ROSS DR STE 425
SYCAMORE IL
60178-3194
US

IV. Provider business mailing address

2560 HAUSER ROSS DR STE 425
SYCAMORE IL
60178-3194
US

V. Phone/Fax

Practice location:
  • Phone: 815-784-6300
  • Fax:
Mailing address:
  • Phone: 815-784-6300
  • 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: KAREN FEDERICI
Title or Position: CEO
Credential: MD
Phone: 815-784-6300