Provider Demographics
NPI:1932835071
Name:PERFECT SILHOUETTE, LLC
Entity Type:Organization
Organization Name:PERFECT SILHOUETTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHALONDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L, CLT
Authorized Official - Phone:219-688-0307
Mailing Address - Street 1:4314 HIDALGO LN
Mailing Address - Street 2:
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3133
Mailing Address - Country:US
Mailing Address - Phone:219-688-0307
Mailing Address - Fax:
Practice Address - Street 1:4314 HIDALGO LN
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3133
Practice Address - Country:US
Practice Address - Phone:219-688-0307
Practice Address - Fax:219-397-5534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-30
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies