Provider Demographics
NPI:1780861674
Name:BALDWIN, ROSEMARY JEANETTE (CNM)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:JEANETTE
Last Name:BALDWIN
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
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Mailing Address - Street 1:2740 W FOSTER AVE
Mailing Address - Street 2:LL7
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-3500
Mailing Address - Country:US
Mailing Address - Phone:773-878-8200
Mailing Address - Fax:773-293-4197
Practice Address - Street 1:5140 N CALIFORNIA AVE
Practice Address - Street 2:SUITE 645
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3645
Practice Address - Country:US
Practice Address - Phone:773-989-6200
Practice Address - Fax:773-989-6201
Is Sole Proprietor?:No
Enumeration Date:2008-01-23
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209003655367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041249546Medicaid
406120042OtherPTAN