Provider Demographics
NPI:1467148775
Name:LACTATIONMD, PLLC
Entity type:Organization
Organization Name:LACTATIONMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MIENA
Authorized Official - Middle Name:MEEK
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, IBCLC
Authorized Official - Phone:224-636-2498
Mailing Address - Street 1:2340 S HIGHLAND AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5371
Mailing Address - Country:US
Mailing Address - Phone:224-636-2498
Mailing Address - Fax:630-656-1048
Practice Address - Street 1:2340 S HIGHLAND AVE STE 280
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5371
Practice Address - Country:US
Practice Address - Phone:224-636-2498
Practice Address - Fax:630-656-1048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty