Healthcare Provider Details

I. General information

NPI: 1780976027
Provider Name (Legal Business Name): CHOICE ACUPUNCTURE & ORIENTAL MEDICINE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 06/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 MIDWEST RD SUITE 100E
OAK BROOK IL
60523-1342
US

IV. Provider business mailing address

1508 S FAIRFIELD AVE APT 6A
LOMBARD IL
60148-4665
US

V. Phone/Fax

Practice location:
  • Phone: 630-568-5942
  • Fax:
Mailing address:
  • Phone: 630-433-0323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number038011371
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038011371
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198000890
License Number StateIL

VIII. Authorized Official

Name: MS. MARGARET ELAINE THOMPSON-CHOI
Title or Position: PRESIDENT
Credential: L.AC.
Phone: 630-433-0323