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General NPI Number Information
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NPI Number | 1164746822
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Entity Type | Individual
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Provider Name | OLGA I MARRERO R.N., IBCLC
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Gender | Female
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Dates
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Enumeration Date | 03/23/2010
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Last Update Date | 03/23/2010
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Provider Practice Location Address
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Address Line | 2233 W DIVISION ST
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City | CHICAGO
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State | IL
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Zip | 60622-8151
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Country | US
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Telephone | 312-770-2883
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 W HAYFORD ST
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City | CHICAGO
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State | IL
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Zip | 60652-1320
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Country | US
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Telephone | 708-650-8076
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP1700X
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Taxonomy Name | Perinatal Registered Nurse
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License Number | 041320946
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License Number State | IL
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