Organization Active NPI

Life With Ben and Jen LLC

  • In Home Supportive Care Agency
  • Mundelein, IL
National Provider Identifier
1821571456
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
LIFE WITH BEN AND JEN LLC
Practice address
816 Benridge CT
Mundelein, IL 60060-1478
Phone
(773) 310-0632
NPI assigned
Sep 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2018

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

Authorized official

Name
Jennifer Ilciuc, RNC-MNN, IBCLC
Title
Lactation Consultant
Phone
(773) 310-0632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

816 Benridge CT
Mundelein, IL 60060-1478

Mailing address

816 Benridge CT
Mundelein, IL 60060-1478

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536537600000",
    "number": "1821571456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 BENRIDGE CT",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 BENRIDGE CT",
            "city": "MUNDELEIN",
            "state": "IL",
            "postal_code": "600601478",
            "telephone_number": "773-310-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE WITH BEN AND JEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A",
        "authorized_official_last_name": "ILCIUC",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "LACTATION CONSULTANT",
        "authorized_official_telephone_number": "773-310-0632",
        "authorized_official_credential": "RNC-MNN, IBCLC"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mundelein, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.