Healthcare Provider Details

I. General information

NPI: 1265023139
Provider Name (Legal Business Name): LAUREN NICOLE SCHULTZ CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2021
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3832 N LINCOLN AVE
CHICAGO IL
60613-3520
US

IV. Provider business mailing address

1472 W FOSTER AVE APT 2
CHICAGO IL
60640-2106
US

V. Phone/Fax

Practice location:
  • Phone: 773-232-2299
  • Fax: 773-232-2293
Mailing address:
  • Phone: 630-542-2220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209019489
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: