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General NPI Number Information
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NPI Number | 1497617484
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Entity Type | Organization
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Legal Business Name | MOON CYCLE MAMA DOULA AND WELLNESS
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Dates
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Enumeration Date | 11/27/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 3838 W 111TH ST
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City | CHICAGO
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State | IL
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Zip | 60655-4095
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Country | US
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Telephone | 773-234-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 1 E ERIE ST STE 525 # 4099
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City | CHICAGO
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State | IL
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Zip | 60611
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Country | US
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Telephone | 773-234-2260
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Fax |
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Authorized Official
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Title or Position | COO
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Name | KERRI HONEYWOOD
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Credential |
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Telephone | 773-642-4707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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