Individual
JEANINE VALRIE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
115 N PARKSIDE AVE, CHICAGO, IL 60644-3040
(773) 295-3060
Mailing address
115 N PARKSIDE AVE, CHICAGO, IL 60644-3040
(773) 295-3060
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
209.019385
IL
Other
Enumeration date
05/14/2019
Last updated
12/27/2019
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