National Provider Identifier Database

CHARDONNAY HENRY
Prosthetist

An individual skilled in the practice, making, use, and application to individual cases of an artificial substitute for a missing body part, such as an arm or leg, eye or tooth, used for functional or cosmetic reasons, or both


Contact Information

CHARDONNAY HENRY
7627 LAKE STREET
SUITE 206 PMB 1005
RIVER FOREST, IL60305-1878
Phone: 708-316-9951
Fax: 708-367-6934
Website:
Specialty Taxonomy Code
* Prosthetist 224P00000X

* Indicates primary specialty

NPI Profile & details for CHARDONNAY HENRY

NPI Number 1275192494
Credentials
Entity Individual
Enumeration date 06/11/2019
Last updated 06/15/2024 - More than a year ago
Sole proprietor1 No
Identifiers
  • IL License #: KAESVF8SO6
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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