Provider Demographics
NPI:1932569738
Name:OGILVIE, KATHLEEN (IBCLC)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:OGILVIE
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 1:1923 W GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4021
Mailing Address - Country:US
Mailing Address - Phone:312-593-1699
Mailing Address - Fax:
Practice Address - Street 1:1923 W GEORGE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4021
Practice Address - Country:US
Practice Address - Phone:312-593-1699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILL-88226174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN