Healthcare Provider Details

I. General information

NPI: 1013481688
Provider Name (Legal Business Name): VINCENT ING CHIROPRACTIC & ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2019
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 RING RD
CALUMET CITY IL
60409-5459
US

IV. Provider business mailing address

1465 RING RD
CALUMET CITY IL
60409-5459
US

V. Phone/Fax

Practice location:
  • Phone: 708-891-1919
  • Fax: 708-891-1956
Mailing address:
  • Phone: 708-891-1919
  • Fax: 708-891-1956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MS. KIMBERLY CHIN
Title or Position: LICENSED ACUPUNCTURIST/OFFICE MGR
Credential: LAC
Phone: 708-891-1919