Provider Demographics
NPI:1760108872
Name:DOULA CONNECT, LLC
Entity Type:Organization
Organization Name:DOULA CONNECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-239-4074
Mailing Address - Street 1:6260 E RIVERSIDE BLVD # 325
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111-4418
Mailing Address - Country:US
Mailing Address - Phone:608-239-4074
Mailing Address - Fax:
Practice Address - Street 1:1620 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:MACHESNEY PARK
Practice Address - State:IL
Practice Address - Zip Code:61115-2117
Practice Address - Country:US
Practice Address - Phone:608-239-4074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty