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NPI Code Detail

MEDICARE: TINA MINGO C.N.M.

MEDICARE:   TINA  MINGO  C.N.M.
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
1367A00000XAdvanced Practice Midwife209-005740IL

General Provider Information

NPI Number : 1114978822
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA MINGO C.N.M.
Provider Business Mailing Address
First Line : 4201 WINFIELD RD FL 4
Second Line :
City : WARRENVILLE
State : IL
Zip : 60555-4025
Country : US
Telephone Number : 331-221-6377
Fax Number : 331-221-2357
Provider Business Practice Location Address
First Line : 1200 S YORK ST STE 4120
Second Line :
City : ELMHURST
State : IL
Zip : 60126-5630
Country : US
Telephone Number : 331-221-9009
Fax Number : 331-221-2750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 05/24/2021

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Directions to “ TINA MINGO C.N.M.” Practice Location

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