Provider Demographics
NPI:1316645286
Name:RICE, CAMILE J (MSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:CAMILE
Middle Name:J
Last Name:RICE
Suffix:
Gender:F
Credentials:MSN, RN, IBCLC
Other - Prefix:
Other - First Name:CAMILE
Other - Middle Name:J
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:756 RUTH DR
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-1930
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:756 RUTH DR
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-1930
Practice Address - Country:US
Practice Address - Phone:224-436-2264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.453627163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant