Organization
ENVISIONING CROWN WIGS CRANIAL PROSTHESIS SPECIALIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAMELA ROSENTHAL C.P.S. (CEO)
(815) 386-6568
Entity
Organization
Contact information
Practice address
475 BROWN BLVD STE 102, BOURBONNAIS, IL 60914-2325
(815) 937-7962
(815) 936-8650
Mailing address
475 BROWN BLVD STE 102, BOURBONNAIS, IL 60914-2325
(815) 937-7962
(815) 936-8650
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
224P00000X
Prosthetist
—
—
Other
Enumeration date
09/05/2025
Last updated
09/05/2025
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