Healthcare Provider Details
I. General information
NPI: 1043145170
Provider Name (Legal Business Name): GLAMMURE AESTHETICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1281 KEIM TRL
BARTLETT IL
60103-7507
US
IV. Provider business mailing address
1281 KEIM TRL
BARTLETT IL
60103-7507
US
V. Phone/Fax
- Phone: 630-313-0829
- Fax:
- Phone: 630-313-0829
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JANICE
COLON
Title or Position: OWNER
Credential: NP
Phone: 630-313-0829