Keri A Boston, RN BSN IBCLC

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

NPI 1285179986 · NPPES record last updated Feb 12, 2025

Key facts

NPI
1285179986
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
L-127068 (IL)
Practice address
1800 Broadway St
Pekin, IL 61554-3822
Phone
(309) 929-0296
Fax
(309) 925-3028
NPI assigned
Jan 4, 2017
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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041.385521ILMDRegistered Nurse
L-127068ILMDLactation Consultant (Registered Nurse)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.385521 IL
Lactation Consultant (Registered Nurse) 163WL0100X L-127068 IL Yes

Addresses

Primary practice location

1800 Broadway St
Pekin, IL 61554-3822

Mailing address

PO Box 1596
Tremont, IL 61568-1596
Phone (309) 202-5393

Other providers in Pekin, IL

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

Sources for this page

Verify at the official NPI Registry.