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Contact Information

LACEY MANIMALA
1026 GUNDERSON AVE
OAK PARK, IL60304-2118
 Phone: 312-509-1616
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
 

Obstetric, High-Risk

163WX0002X
Indicates primary specialty

NPI Profile & details for LACEY MANIMALA · (Female)

NPI Number 1023840725
Status Active
Credentials
Entity Individual
Enumeration date 08/20/2024
Last updated 09/12/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 041.447143
  • IL License # 209030375
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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