Mzcola Beauty Bar

Primary specialty

SpecialistTaxonomy code 174400000X

License

011.301973 Issued in IL

Legal business name

MZCOLA BEAUTY BAR

Practice address

723 Shady Acres LN
Calumet City, IL 60409-3711

Phone

(708) 838-4633

NPI assigned

Mar 19, 2018

Organization subpart

No

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

Authorized official

Name

Dea'Shanay Dorris, COSMETOLOGY

Title

Owner

Phone

(708) 838-4633

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521417600000",
    "number": "1720582596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 SHADY ACRES LN",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604093711",
            "telephone_number": "708-838-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 SHADY ACRES LN",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604093711",
            "telephone_number": "708-838-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MZCOLA BEAUTY BAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-19",
        "last_updated": "2018-03-19",
        "status": "A",
        "authorized_official_last_name": "DORRIS",
        "authorized_official_first_name": "DEA'SHANAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-838-4633",
        "authorized_official_credential": "COSMETOLOGY"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "011.301973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Calumet City, IL
• Providers in Calumet City, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.