Healthcare Provider Details

I. General information

NPI: 1255658910
Provider Name (Legal Business Name): ALTERNATIVE HEALTH ASSOCIATES, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 04/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 S RAND RD
LAKE ZURICH IL
60047-2357
US

IV. Provider business mailing address

504 S RAND RD
LAKE ZURICH IL
60047-2357
US

V. Phone/Fax

Practice location:
  • Phone: 847-955-0800
  • Fax: 847-890-6187
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: GAIL ANN KOPIN-WILL
Title or Position: WELLNESS DIRECTOR
Credential: N.D.
Phone: 847-955-0800