Individual
CECELIA B BACOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
6201 ROOSEVELT RD, BERWYN, IL 60402-1108
(708) 386-0845
(708) 386-8472
Mailing address
6201 ROOSEVELT RD, BERWYN, IL 60402-1108
(708) 386-0845
(708) 386-8472
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
209001981
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209001981
—
IL
Enumeration date
06/10/2006
Last updated
12/23/2019
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