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NPI Code Detail

MEDICARE: SUSAN E WARD CNM

MEDICARE: SUSAN E WARD CNM
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 Midwife309-001206IL

General Provider Information

NPI Number : 1407985682
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN E WARD CNM
Provider Business Mailing Address
First Line : 9765 S WOOD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60643-1620
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 966 W 21ST ST
Second Line :
City : CHICAGO
State : IL
Zip : 60608-4511
Country : US
Telephone Number : 312-829-6030
Fax Number : 312-829-6822
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 07/08/2007

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Directions to “ SUSAN E WARD CNM” Practice Location

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