Healthcare Provider Details

I. General information

NPI: 1962317610
Provider Name (Legal Business Name): VITACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N RAND RD
LAKE ZURICH IL
60047-2297
US

IV. Provider business mailing address

305 N RAND RD
LAKE ZURICH IL
60047-2297
US

V. Phone/Fax

Practice location:
  • Phone: 312-858-8555
  • Fax:
Mailing address:
  • Phone: 312-858-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JANNA DEKSNIS
Title or Position: OWNER
Credential: L.AC.
Phone: 312-858-8555