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NPI Code Detail

MEDICARE: PULLING DOWN THE MOON

MEDICARE: PULLING DOWN THE MOON
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
1133N00000XNutritionist
2171100000XAcupuncturist

General Provider Information

NPI Number : 1952725558
Entity Type Code : Organization
Provider Name (Legal Business Name) : PULLING DOWN THE MOON
Provider Business Mailing Address
First Line : 770 N LA SALLE DR STE 800
Second Line :
City : CHICAGO
State : IL
Zip : 60654-5234
Country : US
Telephone Number : 312-321-0004
Fax Number :
Provider Business Practice Location Address
First Line : 770 N LA SALLE DR STE 800
Second Line :
City : CHICAGO
State : IL
Zip : 60654-5234
Country : US
Telephone Number : 312-321-0004
Fax Number :
Authorized Official
Title or Position : CO-OWNER
Name : TAMARA QUINN
Credential :
Telephone Number : 312-321-0004
Provider Enumeration Date : 02/18/2014
Last Update Date : 05/19/2024

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Directions to “PULLING DOWN THE MOON ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.