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Individual

TARA JANE DETHMERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, CNM

Contact information

Practice address
680 N LAKE SHORE DR STE 815, CHICAGO, IL 60611-4449
(312) 926-5521
(312) 926-8855
Mailing address
680 N LAKE SHORE DR STE 815, CHICAGO, IL 60611-4449
(312) 926-5521
(312) 926-8855

Taxonomy

Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
209014778
IL

Other

Enumeration date
08/31/2016
Last updated
07/12/2024
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