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Individual

LORRAINE BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCD, CBE, PE, SBD

Contact information

Practice address
1427 ACORN DR, NORTH CHICAGO, IL 60064-1764
(708) 522-7150
Mailing address
1600 N MILWAUKEE AVE # 1062, VERNON HILLS, IL 60061-1574
(708) 522-7150

Taxonomy

Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
88-1904965
IL
Enumeration date
10/04/2022
Last updated
10/04/2022
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