Healthcare Provider Details

I. General information

NPI: 1518693936
Provider Name (Legal Business Name): BIRTH PARTNERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2022
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3832 N LINCOLN AVE
CHICAGO IL
60613-3520
US

IV. Provider business mailing address

2107 CRIMSON LN
BLOOMINGTON IL
61704-2742
US

V. Phone/Fax

Practice location:
  • Phone: 773-232-2293
  • Fax:
Mailing address:
  • Phone: 309-361-9199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURA WIEGAND
Title or Position: COO
Credential:
Phone: 309-361-9199