Healthcare Provider Details

I. General information

NPI: 1720685779
Provider Name (Legal Business Name): AROGYA AESTHETICS AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4743 N CLARK ST STE 1S
CHICAGO IL
60640-7020
US

IV. Provider business mailing address

4743 N CLARK ST STE 1S
CHICAGO IL
60640-7020
US

V. Phone/Fax

Practice location:
  • Phone: 312-550-7366
  • Fax: 510-275-0489
Mailing address:
  • Phone: 312-550-7366
  • Fax: 510-275-0489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SHIREEN LONG
Title or Position: MANAGER
Credential: APRN
Phone: 847-791-7654