Healthcare Provider Details

I. General information

NPI: 1427187699
Provider Name (Legal Business Name): MAUREEN MCSWIGGIN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 01/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

966 W 21ST ST
CHICAGO IL
60608-4511
US

IV. Provider business mailing address

1540 N LA SALLE DR APT. 503
CHICAGO IL
60610-1349
US

V. Phone/Fax

Practice location:
  • Phone: 312-829-6030
  • Fax: 312-829-6822
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209-005767
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberRN229102
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: