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General NPI Number Information
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NPI Number | 1184418113
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Entity Type | Organization
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Legal Business Name | EMINERE HAIR LLC
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 2618 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60614-2302
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Country | US
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Telephone | 312-523-8270
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Fax | 312-523-8270
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Provider Business Mailing Address
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Address Line | 2618 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60614-2302
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Country | US
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Telephone | 312-523-8270
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Fax | 312-523-8270
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Authorized Official
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Title or Position | CRANIAL PROSTHESES
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Name | MARLENE DAVID
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Credential | CRANIAL PROSTHESES
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Telephone | 312-523-8270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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