Healthcare Provider Details

I. General information

NPI: 1003735655
Provider Name (Legal Business Name): EMILY O'LOUGHLIN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7702 CASS AVE STE 240
DARIEN IL
60561-5109
US

IV. Provider business mailing address

920 EDDY CT
WHEATON IL
60187-4456
US

V. Phone/Fax

Practice location:
  • Phone: 630-888-9959
  • Fax:
Mailing address:
  • Phone: 773-551-6795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198.001667
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: