Healthcare Provider Details

I. General information

NPI: 1245917202
Provider Name (Legal Business Name): TAYLOR CHAMBERLAIN DNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 W LINCOLN AVE
CHARLESTON IL
61920-2444
US

IV. Provider business mailing address

618 W LINCOLN AVE
CHARLESTON IL
61920-2444
US

V. Phone/Fax

Practice location:
  • Phone: 217-508-4910
  • Fax: 217-508-4909
Mailing address:
  • Phone: 217-508-4910
  • Fax: 217-508-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: