Healthcare Provider Details

I. General information

NPI: 1629980818
Provider Name (Legal Business Name): NEXUS ACUPUNCTURE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 SKOKIE BLVD STE 310
WILMETTE IL
60091-3074
US

IV. Provider business mailing address

2911 WILMETTE AVE
WILMETTE IL
60091-2135
US

V. Phone/Fax

Practice location:
  • Phone: 224-800-2857
  • Fax:
Mailing address:
  • Phone: 224-800-2857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: SEONGHAN AHN
Title or Position: OWNER
Credential:
Phone: 224-800-2857