Healthcare Provider Details

I. General information

NPI: 1629930540
Provider Name (Legal Business Name): KEENA M GARNER CD, PCD, CLS, MHFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KEENA MICHON CD, PCD,CLS

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 E 71ST ST APT 216
CHICAGO IL
60649-2099
US

IV. Provider business mailing address

1935 E 71ST ST APT 216
CHICAGO IL
60649-2099
US

V. Phone/Fax

Practice location:
  • Phone: 773-354-3776
  • Fax:
Mailing address:
  • Phone: 773-354-3776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: