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General NPI Number Information
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NPI Number | 1164146577
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Entity Type | Organization
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Legal Business Name | OPEN ARMS LACTATION LLC
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Dates
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Enumeration Date | 09/29/2022
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 24014 W RENWICK RD UNIT 105
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City | PLAINFIELD
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State | IL
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Zip | 60544-8729
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Country | US
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Telephone | 773-505-7662
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Fax |
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Provider Business Mailing Address
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Address Line | 1569 GLENSIDE DR
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City | BOLINGBROOK
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State | IL
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Zip | 60490-5499
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Country | US
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Telephone | 773-505-7662
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROMA VASUDEV SEAT
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Credential | RD, RN, CLC, IBCLC
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Telephone | 773-505-7662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number |
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License Number State |
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