ELYSE FAGAN


Address: 10430 S Spaulding Ave, Chicago, IL 60655-2427
Phone: 7089459673

ELYSE FAGAN (NPI# 1821520800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1821520800
Entity Type Individual
Full Name ELYSE FAGAN
Credential CNS, IBCLC
Practice Address 10430 S Spaulding Ave
Chicago
IL 60655-2427
Practice Telephone 7089459673
Mailing Telephone 7089459673
Enumeration Date 2017-03-29
Last Update Date 2017-03-29
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WL0100X Registered Nurse
Specialization: Lactation Consultant
041363532 IL Nursing Service Providers

Office Location

Street Address 10430 S SPAULDING AVE
City CHICAGO
State IL
Zip Code 60655-2427

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Taxonomy Information

Taxonomy Code 163WL0100X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Lactation Consultant

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043728322 Nicola Ann Genelly Registered Nurse 4545 W Hutchinson St, Chicago, IL 60641-1989 2018-01-19
1164935102 Jaudon Rogers Registered Nurse 1905 W Foster Ave # 2, Chicago, IL 60640-1025 2017-11-13
1457765075 Summer Glynn Kelly Registered Nurse 4828 N Neenah Ave, Chicago, IL 60656-4018 2014-06-12
1447525449 Elizabeth Susan Sjoblom Registered Nurse 2448 W Bloomingdale Ave, Unit 2w, Chicago, IL 60647-6285 2012-03-09
1235401563 Gwenan Wilbur Registered Nurse 6647 N Talman Ave, Chicago, IL 60645-5008 2012-02-01
1629218227 Laura Coulter Registered Nurse 4538 N Hermitage Ave, Chicago, IL 60640-5304 2009-02-23
1538370994 Martha Petering Johnson Registered Nurse 4138 N Harding Ave, Chicago, IL 60618-1943 2007-05-25
1568680312 Elizabeth Kelly Registered Nurse 4925 N Leavitt St, Chicago, IL 60625-1308 2007-04-24
1194101220 Third Coast Lactation LLC Registered Nurse 4925 N Leavitt St, Chicago, IL 60625-1308 2015-07-30
1306252358 Windy City Baby LLC Registered Nurse 4828 N Neenah Ave, Chicago, IL 60656-4018 2014-07-10
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Competitor

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City CHICAGO
Zip Code 60655

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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