Healthcare Provider Details

I. General information

NPI: 1225745847
Provider Name (Legal Business Name): HEALTHY CONSTELLATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2022
Last Update Date: 11/02/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

666 DUNDEE RD STE 1201
NORTHBROOK IL
60062-2736
US

IV. Provider business mailing address

301 CHIPILI DR
NORTHBROOK IL
60062-4806
US

V. Phone/Fax

Practice location:
  • Phone: 773-245-3089
  • Fax:
Mailing address:
  • Phone: 786-597-0853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIDGET SCHRANK
Title or Position: LICENSED ACUPUNCTURIST AND OWNER
Credential: LAC
Phone: 773-245-2089