NPI 1629138524

Intimate Boutique 2, LTD

Organisation Prosthetic/Orthotic Supplier Highland Park, IL

Practice location

Address: 1833 Second Street, Highland Park, IL 60035
Phone: (847) 432-0220

Authorised official

Name: Angela Fioretto
Title: Office Manager
Phone: (847) 432-0220

Registered specialties

Prosthetic/Orthotic Supplier Primary

Suppliers Taxonomy 335E00000X Licence 15359379 (IL)

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Registry record

NPI: 1629138524
Entity type: Organization
NPI issued: 11 Dec 2006
Record last updated: 10 Mar 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.