Active NPI
Daneita Blalock
- Doula
- Plano, IL
National Provider Identifier
1033864335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- License
- 13451
- Practice address
- 3414 Clason St
Plano, IL 60545-2076 - Phone
- (331) 250-2040
- NPI assigned
- Feb 15, 2022
- Last updated
- Feb 15, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Doula | 374J00000X | 13451 | IL | Primary |
Addresses
Primary practice location
3414 Clason St
Plano, IL 60545-2076
Mailing address
3414 Clason St
Plano, IL 60545-2076
Phone (331) 250-2040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13451 | IL | MD | Doula |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644883200000",
"number": "1033864335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3414 CLASON ST",
"city": "PLANO",
"state": "IL",
"postal_code": "605452076",
"telephone_number": "331-250-2040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3414 CLASON ST",
"city": "PLANO",
"state": "IL",
"postal_code": "605452076",
"telephone_number": "331-250-2040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLALOCK",
"first_name": "DANEITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-15",
"last_updated": "2022-02-15",
"certification_date": "2022-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "IL",
"license": "13451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plano, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.