NPI 1215455852

Bethany Banks, LISCENEDCOSMETOLOGI

Practitioner Prosthetist North Riveride, IL

Practice location

Address: 9161 W. Cermak Rd, North Riveride, IL 60546
Phone: (708) 853-9230

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence 012.007533 (IL)

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Registry record

NPI: 1215455852
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Sep 2017
Record last updated: 21 Jul 2022

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.