Healthcare Provider Details
I. General information
NPI: 1467375022
Provider Name (Legal Business Name): MAISON HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4043 S DREXEL BLVD
CHICAGO IL
60653-2470
US
IV. Provider business mailing address
PO BOX 53614
CHICAGO IL
60653-0614
US
V. Phone/Fax
- Phone: 773-729-7000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174N00000X |
| Taxonomy | Lactation Consultant (Non-RN) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 374J00000X |
| Taxonomy | Doula |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATRINA
MASON
Title or Position: MANAGING MEMBER
Credential:
Phone: 773-729-7000