Provider Demographics
NPI:1326843079
Name:VUCKOVICH, SHEILA (CLC,CD(DONA), ALPP)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:VUCKOVICH
Suffix:
Gender:
Credentials:CLC,CD(DONA), ALPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9257 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-8345
Mailing Address - Country:US
Mailing Address - Phone:708-738-8125
Mailing Address - Fax:
Practice Address - Street 1:9257 ELM AVE
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8345
Practice Address - Country:US
Practice Address - Phone:708-738-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL317382174N00000X
IL1234081374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN