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1861380875 NPI number — JACQUELYN EALEY CLS, CD(DONA)

NPI Number: 1861380875
Health Care Provider/Practitioner: JACQUELYN EALEY CLS, CD(DONA)

Information about “1861380875” NPI (JACQUELYN EALEY CLS, CD(DONA)) exists in 1861380875 in HTML format HTML  |  1861380875 in plain Text format TXT  |  1861380875 in PDF (Portable Document Format) PDF  |  1861380875 in an XML format XML  formats.

NPI Number : 1861380875 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861380875",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "EALEY",
    "FirstName": "JACQUELYN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "CLS, CD(DONA)",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "EALEY",
    "OtherFirstName": "JACKIE",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "CLS. CD(DONA)",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "8849 S OGLESBY AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60617-3038",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "773-733-3384",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8849 S OGLESBY AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60617-3038",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "773-733-3384",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/26/2025",
    "LastUpdateDate": "09/15/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "374J00000X",
          "TaxonomyName": "Doula",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "174N00000X",
          "TaxonomyName": "Lactation Consultant (Non-RN)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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