MEDICARE: DOULA CO MKE LLC

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
1	174N00000X	Lactation Consultant (Non-RN)
2	374J00000X	Doula

General Provider Information

NPI Number	:	1851134019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOULA CO MKE LLC

Provider Business Mailing Address
First Line	:	2901 S WENTWORTH AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-2511
Country	:	US
Telephone Number	:	414-416-7519
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 S WENTWORTH AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53207-2511
Country	:	US
Telephone Number	:	414-416-7519
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. JOAN LEIGH CHMIEL
Credential	:	P&ICD
Telephone Number	:	414-416-7519

Provider Enumeration Date	:	06/17/2024
Last Update Date	:	10/28/2025

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