The Weave Luxe Bar

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

THE WEAVE LUXE BAR

Practice address

7315 Lemont Rd
Downers Grove, IL 60516-3807

Phone

(630) 506-1551

Fax

(252) 650-6564

NPI assigned

Apr 14, 2020

Last updated

Apr 14, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shaylan Pittard

Title

Owner

Phone

(630) 506-1551

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1134748767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7315 LEMONT RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163807",
            "telephone_number": "630-506-1551",
            "fax_number": "252-650-6564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 LEMONT RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605163807",
            "telephone_number": "630-506-1551",
            "fax_number": "252-650-6564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WEAVE LUXE BAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-14",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "PITTARD",
        "authorized_official_first_name": "SHAYLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-506-1551"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "2526506564",
            "affiliation": "N",
            "endpointDescription": "Fax",
            "address_1": "7315 Lemont Rd",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605163807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Prosthetic/Orthotic Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.