Provider Demographics
NPI:1972144962
Name:CAMACHO, FLOR ARROYO (IBCLC)
Entity type:Individual
Prefix:
First Name:FLOR
Middle Name:ARROYO
Last Name:CAMACHO
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 1:17566 65TH AVE
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-4053
Mailing Address - Country:US
Mailing Address - Phone:708-945-4103
Mailing Address - Fax:
Practice Address - Street 1:15941 HARLEM AVE # 298
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-1609
Practice Address - Country:US
Practice Address - Phone:708-480-1387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-141693174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-141693OtherIBCLC