| Charming Skin Med Spa Sc | |
|
2425 W 22nd St Ste 216 Oak Brook IL 60523-4662 | |
| (708) 974-4270 | |
| (888) 466-3320 |
| Full Name | Charming Skin Med Spa Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2425 W 22nd St Ste 216, Oak Brook, Illinois |
| Authorized Official Name and Position | Jawdat Abboud (OWNER) |
| Authorized Official Contact | 7089744270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charming Skin Med Spa Sc 2425 W 22nd St Ste 216 Oak Brook IL 60523-4662 Ph: (708) 974-4270 | Charming Skin Med Spa Sc 2425 W 22nd St Ste 216 Oak Brook IL 60523-4662 Ph: (708) 974-4270 |
| NPI Number | 1710250089 |
|---|---|
| Provider Enumeration Date | 02/17/2012 |
| Last Update Date | 05/18/2012 |
| Medicare PECOS PAC ID | 7416111349 |
|---|---|
| Medicare Enrollment ID | O20120605000762 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710250089 | NPI | - | NPPES |
| 036087208 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jawdat Abboud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417964370 PECOS PAC ID: 2264330901 Enrollment ID: I20031219000501 |
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