Organization
SALLY ANN CORSET SHOP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAYLA L BENDER (PRESIDENT)
(773) 298-1031
Entity
Organization
Contact information
Practice address
10501 S WESTERN AVENUE, CHICAGO, IL 60643-2527
(773) 298-1031
(847) 256-0866
Mailing address
10501 S WESTERN AVENUE, CHICAGO, IL 60643-2527
(773) 298-1031
(847) 256-0866
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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