Individual
NIA IMANI ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4639 N BROADWAY ST APT 304, CHICAGO, IL 60640-5002
(312) 428-1937
Mailing address
4639 N BROADWAY ST APT 304, CHICAGO, IL 60640-5002
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
02/09/2026
Last updated
02/09/2026
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