NPI 1023840725

Lacey Manimala

Practitioner Advanced Practice Midwife Oak Park, IL

Practice location

Address: 1026 Gunderson Ave, Oak Park, IL 60304-2118
Phone: (312) 509-1616

Registered specialties (2)

Advanced Practice Midwife Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367A00000X Licence 209030375 (IL)

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High-Risk Obstetric Registered Nurse

Nursing Service Providers Taxonomy 163WX0002X Licence 041.447143 (IL)

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Registry record

NPI: 1023840725
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Aug 2024
Record last updated: 12 Sep 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.