Organization
ADE ESTHETICS MEDBAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY OSHIPITAN (PRESIDENT)
(773) 870-2970
Entity
Organization
Contact information
Practice address
17907 FAIROAKS DR, COUNTRY CLUB HILLS, IL 60478-2930
(773) 870-2970
Mailing address
17907 FAIROAKS DR, COUNTRY CLUB HILLS, IL 60478-2930
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
12/30/2021
Last updated
12/30/2021
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