Allure Skin and Laser

Organization Active NPI Pediatric Nurse Practitioner · Addison, IL

NPI 1912445800 · NPPES record last updated Feb 10, 2017

Key facts

NPI
1912445800
Entity type
Organization (NPI type 2)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
209015215 (IL)
Legal business name
ALLURE SKIN AND LASER
Practice address
240 E Lake Street
Addison, IL 60101
Phone
(630) 818-7546
NPI assigned
Feb 10, 2017
Organization subpart
No

Authorized official

Name
Dr. Terrah Koppie Gavrilos, D.N.P.
Title
Nurse Practitioner
Phone
22480587113

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LP0200X 209015215 IL Yes

Addresses

Primary practice location

240 E Lake Street
Addison, IL 60101

Mailing address

832 Rosemary Ter
Deerfield, IL 60015
Phone (224) 805-8713

Other providers in Addison, IL

All providers in Addison, IL · Pediatric Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.