Healthcare Provider Details

I. General information

NPI: 1659219475
Provider Name (Legal Business Name): MAMMA JAMMA DANCE & MATERNAL WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3543 S HAMILTON AVE APT 1
CHICAGO IL
60609-1194
US

IV. Provider business mailing address

3543 S HAMILTON AVE APT 1
CHICAGO IL
60609-1194
US

V. Phone/Fax

Practice location:
  • Phone: 312-487-1957
  • Fax:
Mailing address:
  • Phone: 312-487-1957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALITRA CARTMAN
Title or Position: OWNER, CEO
Credential:
Phone: 312-487-1957