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General NPI Number Information
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NPI Number | 1942925847
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Entity Type | Individual
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Provider Name | LORRAINE BLACK BCD, CBE, PE, SBD
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Gender | Female
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Dates
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Enumeration Date | 10/04/2022
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 1427 ACORN DR
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City | NORTH CHICAGO
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State | IL
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Zip | 60064-1764
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Country | US
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Telephone | 708-522-7150
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 N MILWAUKEE AVE # 1062
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City | VERNON HILLS
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State | IL
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Zip | 60061-1574
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Country | US
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Telephone | 708-522-7150
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State | IL
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