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General NPI Number Information
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NPI Number | 1992591614
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Entity Type | Individual
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Provider Name | EMMA KATE PETERSON
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Gender | Female
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 14 LAKE ST
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City | OAK PARK
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State | IL
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Zip | 60302-2606
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Country | US
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Telephone | 708-383-0113
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Fax |
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Provider Business Mailing Address
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Address Line | 808 S BELL AVE APT 2
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City | CHICAGO
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State | IL
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Zip | 60612-3545
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Country | US
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Telephone | 715-218-5837
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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 |
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