Healthcare Provider Details

I. General information

NPI: 1184073108
Provider Name (Legal Business Name): JOSLYNN ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 RIVER TERRACE DR
JOHNSBURG IL
60051-7583
US

IV. Provider business mailing address

1516 RIVER TERRACE DR
JOHNSBURG IL
60051-7583
US

V. Phone/Fax

Practice location:
  • Phone: 773-733-6246
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198001299
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: