MEDICARE: TAO XIONG SMITH LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	198.000586	IL

General Provider Information

NPI Number	:	1528450772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAO XIONG SMITH LAC

Provider Business Mailing Address
First Line	:	859 OAKTON ST
Second Line	:
City	:	ELK GROVE VLG
State	:	IL
Zip	:	60007-1904
Country	:	US
Telephone Number	:	847-867-4105
Fax Number	:

Provider Business Practice Location Address
First Line	:	1784 E OAKTON ST
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60018-2168
Country	:	US
Telephone Number	:	312-282-6461
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2015
Last Update Date	:	03/06/2015

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Directions to “ TAO XIONG SMITH LAC” Practice Location

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