Healthcare Provider Details

I. General information

NPI: 1992900161
Provider Name (Legal Business Name): CHRISTIE HWANG JORDAN L.AC., DIPL.AC.,MSOM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 N DEARBORN ST STE 800
CHICAGO IL
60610-3874
US

IV. Provider business mailing address

650 N DEARBORN ST STE 800
CHICAGO IL
60610-3874
US

V. Phone/Fax

Practice location:
  • Phone: 312-335-9330
  • Fax:
Mailing address:
  • Phone: 312-335-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: