Provider Demographics
NPI:1720306491
Name:CHILDBIRTH THE WAY NATURE INTENDED INC
Entity Type:Organization
Organization Name:CHILDBIRTH THE WAY NATURE INTENDED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOUCHER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-FPA, CNM
Authorized Official - Phone:847-975-7115
Mailing Address - Street 1:40826 N RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:IL
Mailing Address - Zip Code:60002-9545
Mailing Address - Country:US
Mailing Address - Phone:847-975-7115
Mailing Address - Fax:888-959-0674
Practice Address - Street 1:40826 N RIDGE CIR
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:IL
Practice Address - Zip Code:60002-9545
Practice Address - Country:US
Practice Address - Phone:847-975-7115
Practice Address - Fax:888-959-0674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007144367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty