Provider Demographics
NPI:1093271538
Name:NATURAL RESEMBLANCE
Entity Type:Organization
Organization Name:NATURAL RESEMBLANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LETOY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-515-1692
Mailing Address - Street 1:16060 OAK PARK AVE STE 142
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-1626
Mailing Address - Country:US
Mailing Address - Phone:708-515-1692
Mailing Address - Fax:
Practice Address - Street 1:43 WEDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-1077
Practice Address - Country:US
Practice Address - Phone:708-515-1692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment