MEDICARE: KATE OGILVIE LACTATION CONSULTING INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	L-88226	IL

General Provider Information

NPI Number	:	1396198370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATE OGILVIE LACTATION CONSULTING INC.

Provider Business Mailing Address
First Line	:	1923 W GEORGE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-4021
Country	:	US
Telephone Number	:	312-593-1699
Fax Number	:

Provider Business Practice Location Address
First Line	:	1923 W GEORGE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-4021
Country	:	US
Telephone Number	:	312-593-1699
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. KATE OGILVIE
Credential	:	IBCLC
Telephone Number	:	312-593-1699

Provider Enumeration Date	:	07/14/2016
Last Update Date	:	07/14/2016

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