Taylor Jean Petrunich, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-309688 Issued in IL

Practice address

20 Edwardsville Prof Park Ste B
Edwardsville, IL 62025-3602

Phone

(618) 406-6372

NPI assigned

Mar 6, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1083314447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 EDWARDSVILLE PROF PARK STE B",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 EDWARDSVILLE PROF PARK STE B",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253602",
            "telephone_number": "618-406-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUNICH",
        "first_name": "TAYLOR",
        "middle_name": "JEAN",
        "credential": "IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "IL",
            "license": "L-309688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer K. Payne, MA
• Vivian Jean Perry
• Kaleigh Ann Peters
• Kara Peters
• Nathaniel J Peterson, DMD
• Shawnna M Phillips, RN
• Laci Pigg, BT
• Ariana Pinon
• Holly Pirtle, LCPC
• Mary Amanda Amanda Pittman

• Lactation Consultant (Non-RN) in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Lactation Consultant (Non-RN) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.