Healthcare Provider Details

I. General information

NPI: 1588931893
Provider Name (Legal Business Name): CHICAGO INHEALTH CENTER P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 09/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 S MICHIGAN AVE
CHICAGO IL
60616-5522
US

IV. Provider business mailing address

1845 S MICHIGAN AVE C1
CHICAGO IL
60616-5522
US

V. Phone/Fax

Practice location:
  • Phone: 312-949-1289
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038011587
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198001004
License Number StateIL

VIII. Authorized Official

Name: DR. IRIS ZHAO
Title or Position: VICE-PRESIDENT
Credential: D.C., L.AC.
Phone: 773-474-3023