Organization
HAIR HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANITA JACKSON COSMETOLOGIST (MANAGER/HAIR LOSS SPECIALIST)
(312) 286-3736
Entity
Organization
Contact information
Practice address
2600 S MICHIGAN AVE STE 314, CHICAGO, IL 60616-2860
(312) 528-0448
(312) 528-0449
Mailing address
2600 S MICHIGAN AVE STE 314, CHICAGO, IL 60616-2860
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
011-254633
IL
Other
Enumeration date
11/12/2017
Last updated
09/19/2025
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