SKYROSE REJUVENATION CLINIC & SPA LLC NPI 1033736210

NPI Information

NPI: 1033736210
Provider Name: SKYROSE REJUVENATION CLINIC & SPA LLC

Other Name: HEALTHCARE, ESTHETIC PROCEDURES

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
9021 W 151ST ST
ORLAND PARK, IL
ZIP 60462
Phone: (708) 966-4258
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SKYROSE REJUVENATION CLINIC & SPA LLC is a family nurse practitioner in Orland Park, IL. SKYROSE REJUVENATION CLINIC & SPA LLC NPI is 1033736210. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Other Name Is Healthcare, Esthetic Procedures.

The provider's business location address is:

9021 W 151ST ST
ORLAND PARK, IL
ZIP 60462-201
Phone: (708) 966-4258

The provider's authorized official is Chakika L Williams .
The authorized official title is Nurse Practitioner/owner and has the following contact phone number (773) 558-9597.

The CLIA number assigned to this NPI record is 14D2240406 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/3/2020 and was last updated on 3/29/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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