Healthcare Provider Details

I. General information

NPI: 1386842946
Provider Name (Legal Business Name): SUH ALTERNATIVE HEALTH AND PAIN CLINIC SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W GOLF RD
MOUNT PROSPECT IL
60056
US

IV. Provider business mailing address

1600 W GOLF RD
MOUNT PROSPECT IL
60056-4004
US

V. Phone/Fax

Practice location:
  • Phone: 847-364-2424
  • Fax: 847-364-2423
Mailing address:
  • Phone: 847-364-2424
  • Fax: 847-364-2423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038007998
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. DUCKIN SUH
Title or Position: DIRECTOR
Credential: D.C.
Phone: 847-364-2424