Provider Demographics
NPI:1083970552
Name:KRAJECKI, ANITA MARIE (RNC-LRN, BSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:MARIE
Last Name:KRAJECKI
Suffix:
Gender:F
Credentials:RNC-LRN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2091 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2872
Mailing Address - Country:US
Mailing Address - Phone:630-416-8478
Mailing Address - Fax:
Practice Address - Street 1:4043 STATE RT. 59
Practice Address - Street 2:ABC MOMS, INC
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564
Practice Address - Country:US
Practice Address - Phone:630-299-4909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041158806163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant