Provider Demographics
NPI:1093591588
Name:KNAPEREK, BRIDGET LYNN (IBCLC)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:LYNN
Last Name:KNAPEREK
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16745 89TH AVE
Mailing Address - Street 2:
Mailing Address - City:ORLAND HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60487-6003
Mailing Address - Country:US
Mailing Address - Phone:708-745-4910
Mailing Address - Fax:
Practice Address - Street 1:16745 89TH AVE
Practice Address - Street 2:
Practice Address - City:ORLAND HILLS
Practice Address - State:IL
Practice Address - Zip Code:60487-6003
Practice Address - Country:US
Practice Address - Phone:708-745-4910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILL313533174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN