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General NPI Number Information
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NPI Number | 1477914125
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Entity Type | Individual
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Provider Name | ALESSIA L. ELERBY COSMETOLOGIST
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Gender | Female
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Dates
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Enumeration Date | 03/09/2016
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 128 S CASS AVE
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City | WESTMONT
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State | IL
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Zip | 60440
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Country | US
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Telephone | 630-930-8697
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Fax |
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Provider Business Mailing Address
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Address Line | 335 N LATROBE AVE
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City | CHICAGO
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State | IL
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Zip | 60644-2435
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Country | US
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Telephone | 630-930-8697
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | 011169923
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License Number State | IL
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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 | 011169923
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 011169923
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License Number State | IL
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