Healthcare Provider Details

I. General information

NPI: 1730110628
Provider Name (Legal Business Name): MEI LU L. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 03/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 ELM PL SUITE 102A
HIGHLAND PARK IL
60035-2538
US

IV. Provider business mailing address

624 PINE ST
WILMETTE IL
60091-2121
US

V. Phone/Fax

Practice location:
  • Phone: 847-681-8101
  • Fax:
Mailing address:
  • Phone: 847-681-8101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198-000088
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: