Healthcare Provider Details

I. General information

NPI: 1477385599
Provider Name (Legal Business Name): BEAUTY AND HEALTH INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 MIDWEST RD STE 302
OAK BROOK IL
60523-1372
US

IV. Provider business mailing address

2021 MIDWEST RD STE 302
OAK BROOK IL
60523-1372
US

V. Phone/Fax

Practice location:
  • Phone: 224-407-2140
  • Fax:
Mailing address:
  • Phone: 224-407-2140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RUTA KHAN
Title or Position: MEDICAL DIRECTOR
Credential: APRN
Phone: 224-407-2140