Provider Demographics
NPI:1023345725
Name:MEADOWS, VICTORIA (RN, BSN, IBCLC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:MEADOWS
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 1:138 GALE AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-2012
Mailing Address - Country:US
Mailing Address - Phone:708-771-4331
Mailing Address - Fax:
Practice Address - Street 1:138 GALE AVE
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-2012
Practice Address - Country:US
Practice Address - Phone:708-771-4331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041282406163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant