Healthcare Provider Details

I. General information

NPI: 1275511925
Provider Name (Legal Business Name): BARBARA ANN ZIMMERMAN MINNICH C.N.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 S WENTWORTH AVE
CHICAGO IL
60609-6300
US

IV. Provider business mailing address

5401 S WENTWORTH AVE
CHICAGO IL
60609-6300
US

V. Phone/Fax

Practice location:
  • Phone: 773-288-6900
  • Fax: 773-268-3020
Mailing address:
  • Phone: 773-288-6900
  • Fax: 773-268-3020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number100316
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209.009431
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: