Healthcare Provider Details
I. General information
NPI: 1932064615
Provider Name (Legal Business Name): ZEN SHIATSU CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
818 LAKE ST
EVANSTON IL
60201-4317
US
IV. Provider business mailing address
818 LAKE ST
EVANSTON IL
60201-4317
US
V. Phone/Fax
- Phone: 847-864-1130
- Fax:
- Phone: 847-864-1130
- Fax: 847-859-9058
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVE
ROGNE
Title or Position: PRESIDENT
Credential:
Phone: 847-864-1130