Provider Demographics
NPI:1174849152
Name:WALTER, JULI (IBCLC)
Entity Type:Individual
Prefix:
First Name:JULI
Middle Name:
Last Name:WALTER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:JULI
Other - Middle Name:
Other - Last Name:BILLINGS WALTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IBCLC
Mailing Address - Street 1:4719 W BYRON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-6064
Mailing Address - Country:US
Mailing Address - Phone:773-876-7014
Mailing Address - Fax:
Practice Address - Street 1:4719 W BYRON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-6064
Practice Address - Country:US
Practice Address - Phone:773-876-7014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2012-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL107-25869174400000X
IL6820374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No374J00000XNursing Service Related ProvidersDoula