Alyssa Enter

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

041.393663 Issued in IL

Practice address

402 W Council TRL
Mount Prospect, IL 60056-3729

Phone

(847) 220-7705

NPI assigned

Dec 8, 2021

Sex

Male

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mom2Mom Lactation

  • Lactation Consultant (Registered Nurse)
  • Mount Prospect, IL
  • NPI 1063383701
  NPD

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1457019366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W COUNCIL TRL",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600563729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W COUNCIL TRL",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600563729",
            "telephone_number": "847-220-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENTER",
        "first_name": "ALYSSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "IL",
            "license": "041.393663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lactation Consultant (Registered Nurse) in Mount Prospect, IL
• Providers in Mount Prospect, IL by specialty
• Lactation Consultant (Registered Nurse) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.