Provider Demographics
NPI:1417127085
Name:LIPKE, KATHY M (RN, BSN, IBCLC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:M
Last Name:LIPKE
Suffix:
Gender:F
Credentials:RN, BSN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-6342
Mailing Address - Country:US
Mailing Address - Phone:847-509-8302
Mailing Address - Fax:
Practice Address - Street 1:2117 VALLEY RD
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-6342
Practice Address - Country:US
Practice Address - Phone:847-509-8302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant