Angelina C Mendez, LMT, DONA, CLE, LM
Individual provider Active NPI Doula · Momence, IL
NPI 1619600129 · NPPES record last updated Jul 5, 2022
Key facts
- NPI
- 1619600129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Doula 374J00000X
- Practice address
- 17563 E State Route 114
Momence, IL 60954-3822 - Phone
- (708) 407-0908
- NPI assigned
- Jul 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227.020540 | IL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lay Midwife | 175M00000X | |||
| Lactation Consultant (Non-RN) | 174N00000X | |||
| Massage Therapist | 225700000X | 227.020540 | IL | |
| Doula | 374J00000X | Yes |
Addresses
Primary practice location
17563 E State Route 114
Momence, IL 60954-3822
Mailing address
17563 E State Route 114
Momence, IL 60954-3822
Phone (708) 407-0908
Other providers in Momence, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.