Provider Demographics
NPI:1255901112
Name:MCGREGORY, JANAY (COSMETOLOGIST)
Entity type:Individual
Prefix:
First Name:JANAY
Middle Name:
Last Name:MCGREGORY
Suffix:
Gender:F
Credentials:COSMETOLOGIST
Other - Prefix:
Other - First Name:JANAY
Other - Middle Name:
Other - Last Name:CLAIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:22332 GOVERNORS HWY
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-4456
Mailing Address - Country:US
Mailing Address - Phone:708-855-1715
Mailing Address - Fax:
Practice Address - Street 1:5022 THOMAS DR
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-1638
Practice Address - Country:US
Practice Address - Phone:708-855-1715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier