MEDICARE: ANNA PYNE L.AC.

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	198-000383	IL

General Provider Information

NPI Number	:	1881029411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA PYNE L.AC.

Provider Business Mailing Address
First Line	:	900 N KINGSBURY ST
Second Line	:	RIVERWALK 6-A
City	:	CHICAGO
State	:	IL
Zip	:	60610-7432
Country	:	US
Telephone Number	:	312-321-0004
Fax Number	:	312-321-1740

Provider Business Practice Location Address
First Line	:	900 N KINGSBURY ST
Second Line	:	RIVERWALK 6-A
City	:	CHICAGO
State	:	IL
Zip	:	60610-7432
Country	:	US
Telephone Number	:	312-321-0004
Fax Number	:	312-321-1740

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

Provider Enumeration Date	:	09/13/2013
Last Update Date	:	09/13/2013

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Directions to “ ANNA PYNE L.AC.” Practice Location

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