Organization
SHAPERZ INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNN ST. VICTOR-LUCKETT APRN (OWNER)
(773) 875-0069
Entity
Organization
Contact information
Practice address
3754 W 111TH ST UNIT B, CHICAGO, IL 60655-4008
(773) 658-5157
(708) 931-3446
Mailing address
9712 S KEELER AVE, OAK LAWN, IL 60453-3407
(773) 875-0069
(708) 931-3446
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
01/08/2022
Last updated
01/08/2022
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