Desuro Associates LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

04697-91648 Issued in IL

Legal business name

DESURO ASSOCIATES LLC

Doing business as

Images Boutique

Practice address

338 Alana Dr
New Lenox, IL 60451-1784

Phone

(815) 717-6207

NPI assigned

Jan 7, 2016

Organization subpart

No

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

Authorized official

Name

Miss Debra Hansen

Title

Partner

Phone

(815) 685-3010

Specialties & licenses 1

Addresses

Other names 1

• Images Boutique Doing business as

Locations

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452124800000",
    "number": "1508222415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 ALANA DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511784",
            "telephone_number": "815-717-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 ALANA DR",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511784",
            "telephone_number": "815-717-6207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESURO ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-01-07",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "815-685-3010",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "IL",
            "license": "04697-91648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Images Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in New Lenox, IL
• Providers in New Lenox, 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 Jan 7, 2016; 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.