Provider Demographics
NPI:1861783136
Name:PAPILLA ALTERNATIVE HAIR INC.
Entity type:Organization
Organization Name:PAPILLA ALTERNATIVE HAIR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COSMETOLEGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:READ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-724-9987
Mailing Address - Street 1:3520 SEVEN BRIDGES DRIVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517
Mailing Address - Country:US
Mailing Address - Phone:630-724-9987
Mailing Address - Fax:
Practice Address - Street 1:3520 SEVEN BRIDGES DRIVE
Practice Address - Street 2:SUITE 240
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517
Practice Address - Country:US
Practice Address - Phone:630-724-9987
Practice Address - Fax:630-759-7784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL011162386335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier