Provider Demographics
NPI:1154537389
Name:CYGNUS, JEANNE M (IBCLC, PMH-C)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:M
Last Name:CYGNUS
Suffix:
Gender:F
Credentials:IBCLC, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 S LAKE ST STE B
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-4255
Mailing Address - Country:US
Mailing Address - Phone:847-837-4091
Mailing Address - Fax:800-894-1392
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:800-894-1392
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-10936174N00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-10936OtherIBLCE (INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS)