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General NPI Number Information
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NPI Number | 1699588236
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Entity Type | Individual
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Provider Name | PIETRA LILIE HARACZ MS, RD, LDN, CLS
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Gender | Female
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 1111 E JACKSON ST
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City | LOMBARD
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State | IL
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Zip | 60148-3709
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Country | US
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Telephone | 630-682-7400
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Fax | 630-510-5454
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Provider Business Mailing Address
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Address Line | 111 N COUNTY FARM RD
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City | WHEATON
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State | IL
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Zip | 60187-3988
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Country | US
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Telephone |
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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 | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 164.009873
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License Number State | IL
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