Individual
AISHA MUKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COSMETOLGY
Contact information
Practice address
1525 E 55TH ST, CHICAGO, IL 60615-5512
(773) 301-2833
Mailing address
9631 S FOREST AVE, CHICAGO, IL 60628-1473
(773) 301-2833
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
011288433
IL
Other
Enumeration date
01/25/2018
Last updated
01/25/2018
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