Provider Demographics
NPI:1578255675
Name:SOLSTICE IMAGING INC
Entity Type:Organization
Organization Name:SOLSTICE IMAGING INC
Other - Org Name:SOLSTICE BEAUTY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNSHINE
Authorized Official - Middle Name:JONES
Authorized Official - Last Name:BALLENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:312-520-8824
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:630-501-0012
Practice Address - Street 1:651 N YORK ST # A
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:630-530-0112
Practice Address - Fax:312-501-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier