MEDICARE: DANIELLE CHALLENGER LPN, CNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide		IL
2	374J00000X	Doula		IL

General Provider Information

NPI Number	:	1043148216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE CHALLENGER LPN, CNA

Provider Business Mailing Address
First Line	:	4822 ORCHARD AVE
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-2336
Country	:	US
Telephone Number	:	779-208-1203
Fax Number	:	779-208-1203

Provider Business Practice Location Address
First Line	:	4822 ORCHARD AVE
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-2336
Country	:	US
Telephone Number	:	779-208-1203
Fax Number	:	779-208-1203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2026
Last Update Date	:	05/09/2026

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