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Organization
PRESTIGE AESTHETICS AND HYDRATION LOUNGE
Active
Organization
PRESTIGE AESTHETICS AND HYDRATION LOUNGE
Active
Other names
Prestige Aesthetics and Hydration Lounge
Organization subpart
No
Provider details
NPI number
Authorized official
DIESAWIT T HANSOM FNP (FNP)
(720) 343-9799
Entity
Organization
Contact information
Practice address
1761 N DILLEYS RD STE 108-9, GURNEE, IL 60031-1711
(720) 343-9979
Mailing address
1761 N DILLEYS RD STE 108-9, GURNEE, IL 60031-1711
(720) 343-9979
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/12/2023
Last updated
06/12/2023
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