Provider Demographics
NPI:1619690914
Name:ARAWAN ARTISTRY AESTHETICS
Entity Type:Organization
Organization Name:ARAWAN ARTISTRY AESTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUNSHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-421-7400
Mailing Address - Street 1:9114 WAUKEGAN RD UNIT 506
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-3821
Mailing Address - Country:US
Mailing Address - Phone:847-421-7400
Mailing Address - Fax:
Practice Address - Street 1:1883 2ND ST UNIT 38
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3113
Practice Address - Country:US
Practice Address - Phone:847-421-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service