Organization · NPI-2
A Woman'S Connection Of Lasalle-Peru P.C.
Advanced Practice Midwife · Peru, IL
NPI number1760603294
StatusActive
Last updated in NPPESApr 2, 2008
Details
- NPI
- 1760603294
- Entity type
- Organization (NPI-2)
- Legal business name
- A Woman'S Connection Of Lasalle-Peru P.C.
- Organization subpart
- No
- Enumeration date
- May 1, 2007
- Last updated
- Apr 2, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367A00000X | Advanced Practice Midwife | 209-000734 | IL | Yes |
Practice location
2220 Marquette RdPeru, IL 61354-1538
Phone 815-220-0260 · Fax 815-220-8253
Mailing address
2220 Marquette RdPeru, IL 61354-1538
Phone 815-220-0260 · Fax 815-220-8253
Authorized official
Elizabeth Sue Jennings-Porter
Cnm-President
8152200260
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.