Individual provider Active NPI

Marisa Dunn

  • Lactation Consultant (Registered Nurse)
  • Northbrook, IL
National Provider Identifier
1841914454
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
041437509 Issued in IL
Practice address
649 Landwehr Rd
Northbrook, IL 60062-2309
Phone
(847) 272-1500
NPI assigned
Sep 27, 2022
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 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 (Registered Nurse) 163WL0100X 041437509 IL Primary

Addresses

Primary practice location

649 Landwehr Rd
Northbrook, IL 60062-2309

Mailing address

1119 Rago Ave
Deerfield, IL 60015-2143

Other practice location 1

1119 Rago Ave
Deerfield, IL 60015-2143
Phone (847) 840-9953

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
041437509ILMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
New Mother New Baby, LLC Lactation Consultant CurrentSince Oct 2, 2022 Accepting new patients

Locations

649 Landwehr Rd
Northbrook, IL 60062
Phone (847) 272-1500

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": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1841914454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 RAGO AVE",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600152143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 LANDWEHR RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622309",
            "telephone_number": "847-272-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1119 Rago Ave",
            "address_purpose": "LOCATION",
            "city": "Deerfield",
            "state": "IL",
            "postal_code": "600152143",
            "country_code": "US",
            "telephone_number": "847-840-9953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNN",
        "first_name": "MARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "IL",
            "license": "041437509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

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