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ROBERTA'S LOVELY LADIES BOUTIQUE
NPI 1174983050
Mastectomy Fitter in Alton, IL

Active since March 04, 2016
603 W. DELMAR, ALTON, IL 62002(618) 467-0640 Get Directions Write a Review

NPPES record last updated: March 4, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Roberta's Lovely Ladies Boutique NPPES

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

ROBERTA'S LOVELY LADIES BOUTIQUE (NPI 1174983050) is a healthcare organization registered as a mastectomy fitter in Alton, Illinois and active in the NPI registry since March 2016. The organization lists Carol A Logan, Owner, as its authorized official.

NPPES Registry Identity

NPI1174983050
Entity TypeOrganization
Primary Taxonomy224900000X
Legal Business NameROBERTA'S LOVELY LADIES BOUTIQUE
Location Address603 W. DELMARAlton, IL 62002
Mailing Address603 W. DelmarAlton, IL 62002 · (618) 467-0640
Phone(618) 467-0640
Organization SubpartNo
Authorized OfficialCarol A LoganOwner · (618) 467-0095
Enumeration DateMarch 4, 2016
✔ NPI 1174983050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMastectomy FitterRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code224900000X
Definition
An individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services.
603 W. DELMAR, Alton, IL 62002
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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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 2

Medicare supplier enrollment and the product categories Roberta's Lovely Ladies Boutique carries, from the Medicare DMEPOS supplier directory.

Roberta's Lovely Ladies Boutique

DMEPOS supplier · Alton, IL
⋮

Does not accept Medicare assignment

Roberta's Lovely Ladies Boutique has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20477957
Medicare Participant SinceJune 2, 2016
Supplier Location603 W Delmar AveAlton, IL 62002
Phone(618) 467-0640
Supplier Specialties
MSC With Orthotic-Prosthetic

Medicare Product Categories

Breast Prostheses and/or Accessories
Prosthetic bra, Surgical bra
Lymphedema Compression Treatment Items
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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 Roberta's Lovely Ladies Boutique's NPI number?

The NPI number for Roberta's Lovely Ladies Boutique is 1174983050. It was assigned to this organization in the NPPES registry on March 4, 2016.

Where is Roberta's Lovely Ladies Boutique located?

Roberta's Lovely Ladies Boutique is located at 603 W. Delmar, Alton, IL 62002. The listed phone number is (618) 467-0640.

What is Roberta's Lovely Ladies Boutique's specialty?

The primary specialty registered for this NPI is Mastectomy Fitter with taxonomy code 224900000X.

Does Roberta's Lovely Ladies Boutique accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Roberta's Lovely Ladies Boutique does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does Roberta's Lovely Ladies Boutique accept?

Health plans from Anthem Blue Cross and Blue Shield list Roberta's Lovely Ladies Boutique as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Roberta's Lovely Ladies Boutique was last updated on March 4, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.