ANTOINETTE'S WIGS & DAISY BOUTIQUE MASTECTOMY APPEARL (NPI# 1518155670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518155670 |
| Entity Type | Organization |
| Organization Name | ANTOINETTE'S WIGS & DAISY BOUTIQUE MASTECTOMY APPEARL |
| Practice Address |
4714 147th St Midlothian IL 60445-2527 |
| Practice Telephone | 7083855736 |
| Practice Fax Number | 7083855754 |
| Mailing Telephone | 7083855736 |
| Mailing Fax Number | 7083855754 |
| Enumeration Date | 2007-10-13 |
| Last Update Date | 2007-10-13 |
| Authorized Official Name | MISS PATRICIA M LEDDY (OWNER/CERTIFIED FITTER) |
| Authorized Official Telephone | 7083855736 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 31674331 | IL | Suppliers |
| Street Address |
4714 147TH ST |
| City | MIDLOTHIAN |
| State | IL |
| Zip Code | 60445-2527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225254162 | Patricia Leddy | Specialist | 4714 147th St, Midlothian, IL 60445-2527 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861911398 | Paula Marie Jensen Hallahan | Psychologist | Hermansen Elementary School, 101 Wesglen Parkway, Romeoville, IL 60445 | 2017-09-15 |
| 1861933756 | Reginald Castillo | Emergency Medical Technician, Paramedic | 4939 East Circle Dr. #206, Crestwood, IL 60445 | 2017-03-13 |
| 1801259684 | Bruce Frank Leo | Hearing Instrument Specialist | 5553 W. 127th St, Crestwood, IL 60445 | 2016-03-30 |
| 1801291687 | Annie Eyer | Behavioral Analyst | 4942 138th Place, Crestwood, IL 60445 | 2014-10-23 |
| 1679997266 | Phoenix Behavioral Services, Inc | Case Management | 4649 147th Street, Midlothian, IL 60445 | 2014-02-18 |
| 1841537149 | Lacy Carol Little | Speech-Language Pathologist | 14715 Leclaire Ave., Midlothian, IL 60445 | 2013-01-08 |
| 1164709291 | Kathleen Chaudhari | Pharmacist | 4800 W 148th Street, Midlothian, IL 60445 | 2011-11-03 |
| 1063715498 | Amanda Rea Bird | Behavioral Analyst | 5415 129th Pl, Apt 4, Crestwood, IL 60445 | 2010-12-07 |
| 1831376615 | Plaza Nursing & Rehab Center, LLC | Durable Medical Equipment & Medical Supplies | 3249 W 147th St, Midlothiian, IL 60445 | 2008-01-24 |
| 1154475630 | Kevin Martin Bargamian | Dentist | 13549 South Cicero Avenue, Crestwood, IL 60445 | 2007-01-22 |
| Find all providers in zip 60445 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336418995 | Hush Fine Lingerie LLC | Prosthetic/Orthotic Supplier | 15712 Wc Main Strett, Westchester Commons Shopping Center, Midlothian, VA 23113 | 2011-12-27 |
| 1043373780 | Tarif Ihsan Zaki | Prosthetic/Orthotic Supplier | 6169 Harbourside Center Loop, Midlothian, VA 23112-2162 | 2006-12-17 |
| 1326323031 | Capital Orthotics and Prosthetics Technologies, LLC | Prosthetic/Orthotic Supplier | 1500 Huguenot Rd, Suite 106, Midlothian, VA 23113-2478 | 2011-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909517 | Matayah Love | Prosthetic/Orthotic Supplier | 5833 W Madison St, Chicago, IL 60644-3840 | 2020-10-15 |
| 1225653686 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 1290 W Northwest Hwy, Palatine, IL 60067-1897 | 2020-06-11 |
| 1710508239 | Vivian Danielle Williams | Prosthetic/Orthotic Supplier | 940 N Monticello Ave # 1, Chicago, IL 60651-3949 | 2020-05-06 |
| 1265053136 | Dfined Beauty LLC | Prosthetic/Orthotic Supplier | 1507 E 53rd St # 835, Chicago, IL 60615-4573 | 2020-05-02 |
| 1134748767 | The Weave Luxe Bar | Prosthetic/Orthotic Supplier | 7315 Lemont Rd, Downers Grove, IL 60516-3807 | 2020-04-14 |
| 1245865245 | Ortheco LLC | Prosthetic/Orthotic Supplier | 3050 Montvale Dr Ste E, Springfield, IL 62704-4290 | 2020-03-10 |
| 1417515784 | Dionne Williams Group | Prosthetic/Orthotic Supplier | 6822 S Wood St, Chicago, IL 60636-3337 | 2019-06-03 |
| 1164080743 | Bionic Prosthetics and Orthotics Group LLC | Prosthetic/Orthotic Supplier | 391 Quadrangle Dr Ste N4, Bolingbrook, IL 60440-3443 | 2019-05-30 |
| 1760047583 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 13500 Circle Dr Ste 202, Orland Park, IL 60462-1343 | 2019-05-07 |
| 1114580107 | Thomas Gavin | Prosthetic/Orthotic Supplier | 1010 Jorie Blvd Ste 24, Oak Brook, IL 60523-4450 | 2019-04-16 |
| Find all providers with the same taxonomy | ||||
| City | MIDLOTHIAN |
| Zip Code | 60445 |
Please comment or provide details below to improve the information on ANTOINETTE'S WIGS & DAISY BOUTIQUE MASTECTOMY APPEARL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.