# ADE ESTHETICS MEDBAR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104586205
- **Authorized official:** MARY OSHIPITAN (PRESIDENT)
- **Authorized official phone:** (773) 870-2970

## Contact information

- **Practice address:** 17907 FAIROAKS DR, COUNTRY CLUB HILLS, IL 60478-2930
- **Practice address phone:** (773) 870-2970
- **Mailing address:** 17907 FAIROAKS DR, COUNTRY CLUB HILLS, IL 60478-2930

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 247ZC0005X | Clinical Laboratory Director (Non-physician) | — | NULL | Yes |
| 247ZC0005X | Clinical Laboratory Director (Non-physician) | — | — | Yes |

## Other

- **Enumeration date:** 12/30/2021
- **Last updated:** 12/30/2021