Provider Demographics
NPI:1174974034
Name:ONDREYKA, JILLIAN (RDN, IBCLC)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:
Last Name:ONDREYKA
Suffix:
Gender:F
Credentials:RDN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7486 LEAH LN
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-9317
Mailing Address - Country:US
Mailing Address - Phone:810-488-6640
Mailing Address - Fax:
Practice Address - Street 1:7486 LEAH LN
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-9317
Practice Address - Country:US
Practice Address - Phone:810-488-6640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2019-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174N00000XOther Service ProvidersLactation Consultant, Non-RN