Provider Demographics
NPI:1245917202
Name:CHAMBERLAIN, TAYLOR (DNP, CNM)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:DNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 US HIGHWAY 51
Mailing Address - Street 2:
Mailing Address - City:OCONEE
Mailing Address - State:IL
Mailing Address - Zip Code:62553-4193
Mailing Address - Country:US
Mailing Address - Phone:217-722-1988
Mailing Address - Fax:
Practice Address - Street 1:845 S DAMEN AVE # MC802
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3727
Practice Address - Country:US
Practice Address - Phone:312-996-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife