Individual
BETHANY BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISCENED COSMETOLOGI
Contact information
Practice address
9161 W. CERMAK RD, NORTH RIVERIDE, IL 60546
(708) 853-9230
Mailing address
9161 W. CERMAK RD, NORTH RIVERIDE, IL 60546
(708) 853-9230
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
012.007533
IL
Other
Enumeration date
09/04/2017
Last updated
07/21/2022
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