Healthcare Provider Details

I. General information

NPI: 1083244628
Provider Name (Legal Business Name): EQUINOX ACUPUNCTURE AND NAPRAPATHY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 N MILWAUKEE AVE STE 2-29
NILES IL
60714-3237
US

IV. Provider business mailing address

7900 N MILWAUKEE AVE STE 2-29
NILES IL
60714-3237
US

V. Phone/Fax

Practice location:
  • Phone: 708-705-7109
  • Fax: 708-788-1942
Mailing address:
  • Phone: 708-705-7109
  • Fax: 708-788-1942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number
License Number State

VIII. Authorized Official

Name: PAUL ROHACEK
Title or Position: ADMIN
Credential:
Phone: 708-705-7109