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NPI Code Detail

MEDICARE: ALTHEA M NORTHAGE-ORR MA, AHG, L.AC., CST

MEDICARE:   ALTHEA M NORTHAGE-ORR  MA, AHG, L.AC., CST
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
1171100000XAcupuncturist198.000302IL

General Provider Information

NPI Number : 1932613460
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALTHEA M NORTHAGE-ORR MA, AHG, L.AC., CST
Provider Business Mailing Address
First Line : 1622 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60660-1214
Country : US
Telephone Number : 773-764-0960
Fax Number :
Provider Business Practice Location Address
First Line : 1622 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60660-1214
Country : US
Telephone Number : 773-764-0960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2017
Last Update Date : 11/20/2017

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Directions to “ ALTHEA M NORTHAGE-ORR MA, AHG, L.AC., CST” Practice Location

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