Charlene Marie Krause, RN, IBCLC

Individual provider Active NPI Lactation Consultant (Registered Nurse) · Coal City, IL

NPI 1245877364 · NPPES record last updated Dec 9, 2019

Key facts

NPI
1245877364
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
041232568 (IL)
Practice address
2880 N Lincoln Lake Dr
Coal City, IL 60416-9505
Phone
(815) 474-1221
NPI assigned
Dec 9, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041232568ILMDLactation Consultant (Registered Nurse)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse)
Group: 193400000X SINGLE SPECIALTY GROUP
163WL0100X 041232568 IL Yes

Addresses

Primary practice location

2880 N Lincoln Lake Dr
Coal City, IL 60416-9505

Mailing address

2880 N Lincoln Lake Dr
Coal City, IL 60416-9505
Phone (815) 474-1221

Other providers in Coal City, IL

All providers in Coal City, IL · Lactation Consultant (Registered Nurse) in Illinois

Sources for this page

Verify at the official NPI Registry.