Crowning Glory Lace Wigs

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

CROWNING GLORY LACE WIGS

Practice address

8100 S Stony Island Ave
Unit F
Chicago, IL 60617-1734

Phone

(773) 356-9447

Fax

(773) 356-9447

NPI assigned

Jun 24, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kim L Arnold

Title

Owner

Phone

(312) 671-0516

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245801600000",
    "number": "1053549402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 S STONY ISLAND AVE",
            "address_2": "UNIT F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171734",
            "telephone_number": "773-356-9447",
            "fax_number": "773-356-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 S STONY ISLAND AVE",
            "address_2": "UNIT F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606171734",
            "telephone_number": "773-356-9447",
            "fax_number": "773-356-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWNING GLORY LACE WIGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2009-06-24",
        "status": "A",
        "authorized_official_last_name": "ARNOLD",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-671-0516",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Chicago, IL
• Providers in Chicago, IL by specialty
• Customized Equipment (DME) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.