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General NPI Number Information
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NPI Number | 1528886702
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Entity Type | Organization
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Legal Business Name | BEAUTY, FYNE, & FITNESS
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Dates
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Enumeration Date | 09/27/2024
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 4137 SAUK TRL STE 122
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City | RICHTON PARK
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State | IL
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Zip | 60471-1253
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Country | US
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Telephone | 779-267-1025
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Fax |
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Provider Business Mailing Address
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Address Line | 4137 SAUK TRL STE 122
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City | RICHTON PARK
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State | IL
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Zip | 60471-1253
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Country | US
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Telephone | 779-267-1025
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Fax |
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Authorized Official
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Title or Position | CRANIAL PROSTHESIS SPECIALIST
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Name | MRS. JANEL TIFFANY JONES
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Credential |
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Telephone | 708-261-5561
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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 | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #3
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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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