Hillary Maria Kelly, IBCLC

Individual provider Active NPI Lactation Consultant (Non-RN) · Petersburg, IL

NPI 1699549006 · NPPES record last updated Nov 7, 2023

Key facts

NPI
1699549006
Entity type
Individual (NPI type 1)
Primary specialty
Lactation Consultant (Non-RN) 174N00000X
License
L-311402 (IL)
Practice address
15909 Pin Hook Ave
Petersburg, IL 62675-6670
Phone
(217) 671-9635
NPI assigned
Nov 7, 2023
Sex
Female
Sole proprietor
No

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
L-311402ILMDLactation Consultant (Non-RN)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L-311402 IL Yes

Addresses

Primary practice location

15909 Pin Hook Ave
Petersburg, IL 62675-6670

Mailing address

15909 Pin Hook Ave
Petersburg, IL 62675-6670
Phone (217) 671-9635

Other providers in Petersburg, IL

All providers in Petersburg, IL · Lactation Consultant (Non-RN) in Illinois

Sources for this page

Verify at the official NPI Registry.