Individual
JACQUELINE S MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
(312) 829-6375
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
(312) 829-6375
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
209017787
IL
Other
Enumeration date
12/11/2017
Last updated
05/21/2021
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