Skyrose Rejuvenation Clinic & Spa LLC

Key facts

NPI

1033736210

Entity type

Organization (NPI type 2)

Primary specialty

Family Nurse Practitioner 363LF0000X

Legal business name

SKYROSE REJUVENATION CLINIC & SPA LLC

Practice address

9021 W 151St St
Orland Park, IL 60462-3201

Phone

(708) 966-4258

NPI assigned

Jul 3, 2020

Organization subpart

No

Authorized official

Name

Ms. Chakika L Williams, APRN-FNP

Title

Nurse Practitioner/Owner

Phone

(773) 558-9597

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• Healthcare, Esthetic Procedures Other name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 29, 2022.

{
    "created_epoch": "1593734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1033736210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22544 CRESCENT WAY",
            "city": "RICHTON PARK",
            "state": "IL",
            "postal_code": "604711861",
            "telephone_number": "773-558-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9021 W 151ST ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623201",
            "telephone_number": "708-966-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYROSE REJUVENATION CLINIC & SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-03",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CHAKIKA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "773-558-9597",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN-FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthcare, Esthetic Procedures",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Healthcare, Esthetic Procedures",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orland Park, IL

• Anthony Michael Skelly, PHARMD
• Ivana Skokna, OT
• Helen Skrzecz, APRN, CNP
• Skyline Orthopedics, LLC
• Skyrose Clinical & Consultant SVCS.
• Jessica Slager
• Joan Teresa Slawinski, LCPC
• Angelica Maria Sloan
• Maja Slowik, DMD
• Carolyn Sluis

All providers in Orland Park, IL · Family Nurse Practitioner in Illinois