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Contact Information

GRACE G LARSON, CNM
3860 W OGDEN AVE
CHICAGO, IL60623-8400
 Phone: 872-588-3000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Advanced Practice Midwife

367A00000X 42 Certified Nurse Midwife
 

Midwife

176B00000X
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for GRACE G LARSON · (Female)

NPI Number 1609279819
Status Active
Credentials CNM (Certified Nurse Midwife)
Entity Individual
Enumeration date 10/01/2014
Last updated 03/07/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 041374899
  • IL License # 209011927
  • IL Other 309017757 CS LICENSE
  • IL Other 209011927 STATE LICENSE
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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