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General NPI Number Information
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NPI Number | 1720997844
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Entity Type | Individual
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Provider Name | TAMARA GLOVER-SIMS LICENSED COSMETOLOGI
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Gender | Female
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Dates
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Enumeration Date | 09/03/2026
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Last Update Date | 09/03/2026
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Provider Practice Location Address
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Address Line | 4550 W 103RD ST STE 303K
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City | OAK LAWN
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State | IL
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Zip | 60453-4868
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Country | US
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Telephone | 224-201-1234
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Fax | 708-570-6944
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Provider Business Mailing Address
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Address Line | 4550 W 103RD ST STE 303K
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City | OAK LAWN
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State | IL
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Zip | 60453-4868
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Country | US
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Telephone | 224-201-1234
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Fax | 708-570-6944
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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 | 224P00000X
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Taxonomy Name | Prosthetist
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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 | 225000000X
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Taxonomy Name | Orthotic Fitter
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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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