Individual provider Active NPI

Carolyn L Thompson, IBCLC

  • Lactation Consultant (Non-RN)
  • Chicago, IL
National Provider Identifier
1699664474
Registry record updated Jun 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-319085 Issued in NV
Practice address
1621 W Carroll Ave
Chicago, IL 60612-2501
Phone
(888) 510-0059
NPI assigned
Jun 28, 2025
Last updated
Jun 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L-319085 NV Primary

Addresses

Primary practice location

1621 W Carroll Ave
Chicago, IL 60612-2501

Mailing address

PO Box 1442
Logandale, NV 89021-1442

Other practice location 1

1223 E Green Rd
Fruit Heights, UT 84037-2245
Phone (801) 513-3255

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

State licenses

LicenseStateTypeSpecialty
L-319085NVMDLactation Consultant (Non-RN)

Practice roles

OrganizationSpecialtyStatusNew patients
Infant Massage With Bri PastSince Sep 11, 2022 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1751068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751068800000",
    "number": "1699664474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1442",
            "city": "LOGANDALE",
            "state": "NV",
            "postal_code": "890211442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 W CARROLL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122501",
            "telephone_number": "888-510-0059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1223 E Green Rd",
            "address_purpose": "LOCATION",
            "city": "Fruit Heights",
            "state": "UT",
            "postal_code": "840372245",
            "country_code": "US",
            "telephone_number": "801-513-3255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CAROLYN",
        "middle_name": "L",
        "credential": "IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-28",
        "last_updated": "2025-06-28",
        "certification_date": "2025-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "NV",
            "license": "L-319085",
            "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 Jun 28, 2025; 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.