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BEDAZZLED SALON AND SPA
NPI 1124309919
Specialist in Roscoe, IL

Active since September 07, 2011
11708 MAIN ST, ROSCOE, IL 61073(815) 389-4965 Get Directions Write a Review

NPPES record last updated: September 7, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bedazzled Salon And Spa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEDAZZLED SALON AND SPA (NPI 1124309919) is a healthcare organization registered as a specialist in Roscoe, Illinois and active in the NPI registry since September 2011. The organization lists Anthony Jenkins, Owner, as its authorized official.

NPPES Registry Identity

NPI1124309919
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameBEDAZZLED SALON AND SPA
Location Address11708 MAIN STRoscoe, IL 61073-9566
Mailing Address11708 Main StRoscoe, IL 61073-9566
Phone(815) 389-4965
Organization SubpartNo
Authorized OfficialAnthony JenkinsOwner · (815) 389-4965
Enumeration DateSeptember 7, 2011
✔ NPI 1124309919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
11708 MAIN ST, Roscoe, IL 61073
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bedazzled Salon And Spa's NPI number?

The NPI number for Bedazzled Salon And Spa is 1124309919. It was assigned to this organization in the NPPES registry on September 7, 2011.

Where is Bedazzled Salon And Spa located?

Bedazzled Salon And Spa is located at 11708 Main St, Roscoe, IL 61073. The listed phone number is (815) 389-4965.

What is Bedazzled Salon And Spa's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Bedazzled Salon And Spa was last updated on September 7, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.