MEDICARE: CHICAGOLAND BREASTFEEDING

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	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1588958961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGOLAND BREASTFEEDING

Provider Business Mailing Address
First Line	:	1213 W GLENN LN
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4014
Country	:	US
Telephone Number	:	847-308-7367
Fax Number	:

Provider Business Practice Location Address
First Line	:	1213 W GLENN LN
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4014
Country	:	US
Telephone Number	:	847-308-7367
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SHEILA M ZAGONE
Credential	:	BA, IBCLC, RLC
Telephone Number	:	847-308-7367

Provider Enumeration Date	:	06/03/2011
Last Update Date	:	06/03/2011

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Directions to “CHICAGOLAND BREASTFEEDING ” Practice Location

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