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General NPI Number Information
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NPI Number | 1396683660
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Entity Type | Organization
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Legal Business Name | THEE LUXPERIENCE
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 2150 S CANALPORT AVE STE 5C6
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City | CHICAGO
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State | IL
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Zip | 60608-0494
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Country | US
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Telephone | 312-735-3755
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Fax |
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Provider Business Mailing Address
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Address Line | 111 N WABASH AVE STE 3944
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City | CHICAGO
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State | IL
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Zip | 60602-1903
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Country | US
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Telephone | 312-735-3755
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | LAKENDRA GRAHAM
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Credential |
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Telephone | 312-735-3755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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