Individual provider Active NPI

Aisha Mukes, COSMETOLGY

  • Prosthetic/Orthotic Supplier
  • Chicago, IL
National Provider Identifier
1164920146
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
011288433 Issued in IL
Practice address
1525 E 55TH St
Chicago, IL 60615-5512
Phone
(773) 301-2833
NPI assigned
Jan 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 011288433 IL Primary

Addresses

Primary practice location

1525 E 55TH St
Chicago, IL 60615-5512

Mailing address

9631 S Forest Ave
Chicago, IL 60628-1473
Phone (773) 301-2833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
011288433ILMDProsthetic/Orthotic Supplier

NPI Registry JSON

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1164920146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9631 S FOREST AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281473",
            "telephone_number": "773-301-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606155512",
            "telephone_number": "773-301-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKES",
        "first_name": "AISHA",
        "credential": "COSMETOLGY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "IL",
            "license": "011288433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.