Individual
MICHELLE RENEE DORMANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2653 W OGDEN AVE, CHICAGO, IL 60608
(773) 257-6508
Mailing address
1500 S. FAIRFIELD AVE, CHICAGO, IL 60608
(737) 257-6691
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
041.431303
IL
367A00000X
Advanced Practice Midwife
Primary
CNM04289
—
367A00000X
Advanced Practice Midwife
—
—
Other
Enumeration date
09/11/2018
Last updated
03/11/2022
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