Provider Demographics
NPI:1962605824
Name:WOMEN FIRST MIDWIFERY
Entity type:Organization
Organization Name:WOMEN FIRST MIDWIFERY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:RIDDELL
Authorized Official - Suffix:
Authorized Official - Credentials:APN CNM
Authorized Official - Phone:630-897-7700
Mailing Address - Street 1:1300 N HIGHLAND AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-1464
Mailing Address - Country:US
Mailing Address - Phone:630-897-7700
Mailing Address - Fax:
Practice Address - Street 1:1300 N HIGHLAND AVE STE 5
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1464
Practice Address - Country:US
Practice Address - Phone:630-897-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL332462735001Medicaid