| Moms Lactation Resource Center | |
|
506 N Elida Winnebago IL 61088 | |
| (815) 222-4596 | |
| Not Available |
| Full Name | Moms Lactation Resource Center |
|---|---|
| Speciality | Clinic/center |
| Location | 506 N Elida, Winnebago, Illinois |
| Authorized Official Name and Position | Jennifer Beck (CO-MANAGER) |
| Authorized Official Contact | 8152224596 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moms Lactation Resource Center 984 Westridge Dr. Rockford IL 61102 Ph: (815) 222-4596 | Moms Lactation Resource Center 506 N Elida Winnebago IL 61088 Ph: (815) 222-4596 |
| NPI Number | 1255803466 |
|---|---|
| Provider Enumeration Date | 12/28/2018 |
| Last Update Date | 12/28/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255803466 | NPI | - | NPPES |
| 187065250 | Medicaid | IL | |
| 1821569120 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |