MEDICARE: LINDSEY AVINK

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	374J00000X	Doula

General Provider Information

NPI Number	:	1174894190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY AVINK

Provider Business Mailing Address
First Line	:	1506 S CHRISTIANA AVE
Second Line	:	UNIT 2
City	:	CHICAGO
State	:	IL
Zip	:	60623-2151
Country	:	US
Telephone Number	:	312-515-0563
Fax Number	:

Provider Business Practice Location Address
First Line	:	1506 S CHRISTIANA AVE
Second Line	:	UNIT 2
City	:	CHICAGO
State	:	IL
Zip	:	60623-2151
Country	:	US
Telephone Number	:	312-515-0563
Fax Number	:

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

Provider Enumeration Date	:	01/23/2012
Last Update Date	:	01/23/2012

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Directions to “ LINDSEY AVINK ” Practice Location

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