Individual provider Active NPI

Nallyve Candelo, RN IBCLC

  • Lactation Consultant (Registered Nurse)
  • Chicago, IL
National Provider Identifier
1265160873
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
041389658 Issued in IL
Practice address
5400 N Lovejoy Ave
Chicago, IL 60630-1214
Phone
(773) 942-3702
NPI assigned
Aug 11, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 041389658 IL Primary

Addresses

Primary practice location

5400 N Lovejoy Ave
Chicago, IL 60630-1214

Mailing address

5400 N Lovejoy Ave
Chicago, IL 60630-1214
Phone (773) 942-3702

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041389658ILMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1265160873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 N LOVEJOY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301214",
            "telephone_number": "773-942-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 N LOVEJOY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301214",
            "telephone_number": "773-942-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDELO",
        "first_name": "NALLYVE",
        "credential": "RN IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "IL",
            "license": "041389658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.