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General NPI Number Information
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NPI Number | 1336076546
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Entity Type | Organization
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Legal Business Name | PROFOUND BIRTH PLLC
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Dates
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Enumeration Date | 05/04/2026
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Last Update Date | 05/04/2026
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Provider Practice Location Address
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Address Line | 155 CHICAGO RD FL 1
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City | OSWEGO
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State | IL
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Zip | 60543-9461
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Country | US
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Telephone | 630-724-5620
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Fax |
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Provider Business Mailing Address
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Address Line | 405 FRANKFORT AVE
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City | OSWEGO
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State | IL
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Zip | 60543-7756
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Country | US
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Telephone | 630-724-5620
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAYA WILLIAMS
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Credential | LCPM, CPM, LM
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Telephone | 312-656-1109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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