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NPI Code Detail

MEDICARE: MS. LOREL MAYER NEAL MSN,CNM

MEDICARE: MS. LOREL MAYER NEAL MSN,CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife209003672IL
2367A00000XAdvanced Practice Midwife277.000976IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101621679OTHERILBCBS OF IL

General Provider Information

NPI Number : 1073596599
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LOREL MAYER NEAL MSN,CNM
Provider Business Mailing Address
First Line : PO BOX 689022
Second Line :
City : FRANKLIN
State : TN
Zip : 37068-9022
Country : US
Telephone Number : 615-465-7632
Fax Number : 615-465-2885
Provider Business Practice Location Address
First Line : 5525 S PULASKI RD
Second Line :
City : CHICAGO
State : IL
Zip : 60629-4417
Country : US
Telephone Number : 773-585-1955
Fax Number : 773-284-5268
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 10/19/2021

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