Healthcare Provider Details

I. General information

NPI: 1912822107
Provider Name (Legal Business Name): DANIELLE HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 S CALIFORNIA AVE
CHICAGO IL
60608-1681
US

IV. Provider business mailing address

1301 S CALIFORNIA AVE
CHICAGO IL
60608-1681
US

V. Phone/Fax

Practice location:
  • Phone: 773-759-2257
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number209.035975
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: