Provider Demographics
NPI:1417386228
Name:BALDAUF, ERIN (IBCLC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:BALDAUF
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 1:713 BROOKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1203
Mailing Address - Country:US
Mailing Address - Phone:312-720-3505
Mailing Address - Fax:
Practice Address - Street 1:713 BROOKSIDE LN
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1203
Practice Address - Country:US
Practice Address - Phone:312-720-3505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILL-46883174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN