Provider Demographics
NPI:1073050571
Name:WINDSORS LIFT BODY
Entity Type:Organization
Organization Name:WINDSORS LIFT BODY
Other - Org Name:LIFT BODY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATION MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-278-1885
Mailing Address - Street 1:1321 TOWER RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4384
Mailing Address - Country:US
Mailing Address - Phone:847-278-1885
Mailing Address - Fax:630-635-2496
Practice Address - Street 1:1321 TOWER RD
Practice Address - Street 2:SUITE A
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4384
Practice Address - Country:US
Practice Address - Phone:847-278-1885
Practice Address - Fax:630-635-2496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036122339208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty