Healthcare Provider Details

I. General information

NPI: 1811905151
Provider Name (Legal Business Name): BETTY SCHLATTER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 W WELLINGTON AVE
CHICAGO IL
60657-5147
US

IV. Provider business mailing address

836 W WELLINGTON AVE
CHICAGO IL
60657-5147
US

V. Phone/Fax

Practice location:
  • Phone: 773-296-7032
  • Fax: 773-296-3096
Mailing address:
  • Phone: 773-296-7032
  • Fax: 773-296-3096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: