Judy Ann Bergsmith, RN-IBCLC

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

NPI 1497087282 · NPPES record last updated Feb 4, 2010

Key facts

NPI
1497087282
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Registered Nurse) 163WL0100X
License
041.231280 (IL)
Practice address
147 N 2ND St
Suite 11
Dekalb, IL 60115-3276
Phone
(815) 517-1783
Fax
(815) 517-1783
NPI assigned
Feb 4, 2010
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

State licenses

LicenseStateTypeSpecialty
041.231280ILMDLactation Consultant (Registered Nurse)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 041.231280 IL Yes

Addresses

Primary practice location

147 N 2ND St
Suite 11
Dekalb, IL 60115-3276

Mailing address

147 N 2ND St
Suite 11
Dekalb, IL 60115-3276
Phone (815) 517-1783

Other providers in Dekalb, IL

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

Sources for this page

Verify at the official NPI Registry.