Healthcare Provider Details

I. General information

NPI: 1447179981
Provider Name (Legal Business Name): EMERGENT HOUSING SOULUTIONS LLC-BARE CANVAS ELECTROLYSIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6851 167TH ST STE 22
TINLEY PARK IL
60477-2501
US

IV. Provider business mailing address

1315 EAST ST
CRETE IL
60417-2241
US

V. Phone/Fax

Practice location:
  • Phone: 779-900-7304
  • Fax:
Mailing address:
  • Phone: 779-900-7304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: LATOSHA C MALONE
Title or Position: OWNER/ELECTROLOGIST
Credential: LE
Phone: 779-900-7304