1144702036 NPI number — LABOR OF LOVE MIDWIFERY AND WOMEN HEALTH SERVICES LLC

Table of content: (NPI 1144702036)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144702036 NPI number — LABOR OF LOVE MIDWIFERY AND WOMEN HEALTH SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABOR OF LOVE MIDWIFERY AND WOMEN HEALTH SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144702036
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12188 N 920TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROBINSON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62454-4314
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
618-553-8369
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
309 N JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROBINSON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62454-2722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-553-8369
Provider Business Practice Location Address Fax Number:
959-666-6204
Provider Enumeration Date:
09/06/2018

Additional Information

Authorized Official

Authorized Official Last Name:
LOWRANCE
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
B
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
618-553-8369

Provider Taxonomy Codes

  • Taxonomy code: 176B00000X , with the licence number:  209010085 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 343561312001 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com