Healthcare Provider Details

I. General information

NPI: 1194534206
Provider Name (Legal Business Name): ALYSSA PEREZ ACUPUNCTURE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2025
Last Update Date: 01/03/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 W ARMITAGE AVE
CHICAGO IL
60647-4341
US

IV. Provider business mailing address

823 W WAVELAND AVE APT 1S
CHICAGO IL
60613-4329
US

V. Phone/Fax

Practice location:
  • Phone: 956-926-9904
  • Fax:
Mailing address:
  • Phone: 956-926-9904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: ALYSSA MARIE PEREZ
Title or Position: ACUPUNCTURIST/MASSAGE THERAPIST
Credential: LAC, LMT
Phone: 956-926-9904