Provider Demographics
NPI:1700513272
Name:PARKER, SONRISA HANSEN (IBCLC)
Entity Type:Individual
Prefix:
First Name:SONRISA
Middle Name:HANSEN
Last Name:PARKER
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 1:6702 KING CT
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1529
Mailing Address - Country:US
Mailing Address - Phone:630-242-0929
Mailing Address - Fax:
Practice Address - Street 1:3717 N RAVENSWOOD AVE STE 140
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1164
Practice Address - Country:US
Practice Address - Phone:630-242-0929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN