Provider Demographics
NPI:1003552647
Name:BODI BY ME MED SPA LLC
Entity Type:Organization
Organization Name:BODI BY ME MED SPA LLC
Other - Org Name:BODI BY ME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HANDSPIKE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:773-458-8450
Mailing Address - Street 1:12911 S EMERALD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-7428
Mailing Address - Country:US
Mailing Address - Phone:773-458-8450
Mailing Address - Fax:
Practice Address - Street 1:12911 S EMERALD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-7428
Practice Address - Country:US
Practice Address - Phone:773-458-8450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty