Provider Demographics
NPI:1417771759
Name:J4 & BEAUX LLC
Entity type:Organization
Organization Name:J4 & BEAUX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLUSHOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUYEBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-803-0093
Mailing Address - Street 1:12617 BLUE IRIS LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-2857
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12617 BLUE IRIS LN
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-2857
Practice Address - Country:US
Practice Address - Phone:630-803-0093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health