MEDICARE: BARBARA DORAN APRN, 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
1	367A00000X	Advanced Practice Midwife	277.000610	IL

General Provider Information

NPI Number	:	1669541371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA DORAN APRN, CNM

Provider Business Mailing Address
First Line	:	3700 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-3824
Country	:	US
Telephone Number	:	773-542-5203
Fax Number	:	773-542-5841

Provider Business Practice Location Address
First Line	:	2653 W OGDEN AVE STE 3B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1647
Country	:	US
Telephone Number	:	773-522-6100
Fax Number	:	773-522-9832

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	04/23/2021

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