Active NPI
Amanda Smith, IBCLC
- Lactation Consultant (Non-RN)
- Morton, IL
National Provider Identifier
1144062936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Non-RN)
- License
- L-309982
- Practice address
- 344 S Carol Ave
Morton, IL 61550-1902 - Phone
- (630) 854-0455
- NPI assigned
- Jun 11, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | L-309982 | IL | Primary |
Addresses
Primary practice location
344 S Carol Ave
Morton, IL 61550-1902
Mailing address
344 S Carol Ave
Morton, IL 61550-1902
Phone (630) 854-0455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-309982 | IL | MD | Lactation Consultant (Non-RN) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718064000000",
"number": "1144062936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "344 S CAROL AVE",
"city": "MORTON",
"state": "IL",
"postal_code": "615501902",
"telephone_number": "630-854-0455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "344 S CAROL AVE",
"city": "MORTON",
"state": "IL",
"postal_code": "615501902",
"telephone_number": "630-854-0455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "AMANDA",
"credential": "IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-11",
"last_updated": "2024-06-11",
"certification_date": "2024-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "IL",
"license": "L-309982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.