Provider Demographics
NPI:1083325781
Name:BALLENTINE, SUNSHINE JONES (CERTIFIED HAIR LOSS)
Entity Type:Individual
Prefix:MRS
First Name:SUNSHINE
Middle Name:JONES
Last Name:BALLENTINE
Suffix:
Gender:F
Credentials:CERTIFIED HAIR LOSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 N YORK ST APT 603
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1256
Mailing Address - Country:US
Mailing Address - Phone:312-520-8824
Mailing Address - Fax:
Practice Address - Street 1:651 N YORK ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-1604
Practice Address - Country:US
Practice Address - Phone:312-520-8824
Practice Address - Fax:630-501-0012
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist