Healthcare Provider Details

I. General information

NPI: 1659288199
Provider Name (Legal Business Name): JOYCE VALLEJO DAC, L.AC., DIPL. AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 WAUKEGAN RD STE 102
NORTHFIELD IL
60093-2743
US

IV. Provider business mailing address

191 WAUKEGAN RD STE 102
NORTHFIELD IL
60093-2743
US

V. Phone/Fax

Practice location:
  • Phone: 847-868-0408
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198.011973
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: