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Southwest Aesthetics And Body Sculpture, Llc
Specialist in Shorewood, Illinois
NPI 1609017011

Southwest Aesthetics And Body Sculpture, Llc is a Specialist based in Olympia, IL. Southwest Aesthetics And Body Sculpture, Llc practices in Shorewood, IL. The NPI Number for Southwest Aesthetics And Body Sculpture, Llc is 1609017011 and holds a License No. 1371 (Illinois).

The current practice location address for Southwest Aesthetics And Body Sculpture, Llc is 217 Vertin Blvd, Shorewood, IL and can be reached out via phone at 815-545-9772.

Location: 217 Vertin Blvd, Shorewood, IL, 98508-1009
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1609017011
Provider Name
Southwest Aesthetics And Body Sculpture, Llc
Credential
Provider Entity Type
Organization
Address
217 Vertin Blvd, Shorewood, IL, 98508-1009
Phone Number
815-545-9772
Fax Number
Provider Enumeration Date
03/13/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036088162 05 IL
036065985 05 IL
P00870505 01 IL RR MEDICARE PALMETTO GBA
036087434 05 IL
P00870409 01 IL RR MEDICARE PALMETTO GBA
DQ7598 01 IL RR MEDICARE PALMETTO GBA
036053917 05 IL
institution
Provider Business Practice Location Address Details
Address
217 Vertin Blvd
City
Shorewood
State
Illinois
Zip
60404-8783
Phone Number
815-545-9772
Fax Number
person
Provider Business Mailing Address Details
Address
217 Vertin Blvd
City
Shorewood
State
Illinois
Zip
60404-8783
Phone Number
815-545-9772
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
1371 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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