Organization
BEAUTY IMAGE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH C. M. MCNICHOLAS CPC (BILLING COORDINATOR)
(847) 965-8552
Entity
Organization
Contact information
Practice address
1280 BAMBERG CT, HANOVER PARK, IL 60103
(630) 483-9225
(630) 483-1958
Mailing address
1280 BAMBERG CT, HANOVER PARK, IL 60103
(630) 483-9225
(630) 483-1958
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
11227254
IL
Other
Enumeration date
07/13/2007
Last updated
07/13/2007
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