Healthcare Provider Details

I. General information

NPI: 1447585740
Provider Name (Legal Business Name): AMIE SHIMMEL HANDA D.C.,L.A.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 04/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E SUPERIOR ST SUITE 307
CHICAGO IL
60611-2507
US

IV. Provider business mailing address

1 E SUPERIOR ST SUITE 307
CHICAGO IL
60611-2507
US

V. Phone/Fax

Practice location:
  • Phone: 312-664-8376
  • Fax: 312-664-8417
Mailing address:
  • Phone: 312-664-8376
  • Fax: 312-664-8417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038006395
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198001361
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: