Provider Demographics
NPI:1699362459
Name:SEDLACK, JANICE (IBCLC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:SEDLACK
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 1:556 BIRCH RD
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-2753
Mailing Address - Country:US
Mailing Address - Phone:847-830-3351
Mailing Address - Fax:
Practice Address - Street 1:1500 S LAKE ST STE B
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-4255
Practice Address - Country:US
Practice Address - Phone:847-837-4091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN