Organization
BELLE SOI AESTHETICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT RUSCO DO (MEDICAL DIRECTOR)
(708) 892-1177
Entity
Organization
Contact information
Practice address
9953 W 143RD ST, ORLAND PARK, IL 60462-2024
(708) 892-1177
Mailing address
9953 W 143RD ST, ORLAND PARK, IL 60462-2024
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942782016
—
IL
Enumeration date
10/01/2024
Last updated
10/01/2024
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