LACEY MANIMALA

OAK PARK, IL
NPI1023840725
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367A00000X Advanced Practice Midwife
(Licence: IL  209030375)
Additional Taxonomies163WX0002X Registered Nurse, Obstetric, High-Risk
(Licence: IL  041.447143)
Enumeration Date2024-08-20
Last Update Date2024-09-12
Business Address
LACEY MANIMALA
1026 GUNDERSON AVE
OAK PARK, IL 60304-2118
Phone number: 312-509-1616
Mailing Address
LACEY MANIMALA
1026 GUNDERSON AVE
OAK PARK, IL 60304-2118
Phone number: 312-509-1616