Provider Demographics
NPI:1518661800
Name:DELAUGHTER-YOUNG, JAMILLIA
Entity Type:Individual
Prefix:
First Name:JAMILLIA
Middle Name:
Last Name:DELAUGHTER-YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JAMILLIA
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4923 W IOWA ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-3113
Mailing Address - Country:US
Mailing Address - Phone:773-968-0865
Mailing Address - Fax:
Practice Address - Street 1:4923 W IOWA ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-3113
Practice Address - Country:US
Practice Address - Phone:773-968-0865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No172V00000XOther Service ProvidersCommunity Health Worker