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General NPI Number Information
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NPI Number | 1013193937
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Entity Type | Organization
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Legal Business Name | WANG CHIROPRACTIC & ACUPUNCTURE CLINIC PC
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 552 S YORK ST # A
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City | ELMHURST
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State | IL
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Zip | 60126-4479
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Country | US
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Telephone | 163-094-1123
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Fax |
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Provider Business Mailing Address
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Address Line | 552 S YORK ST # A
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City | ELMHURST
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State | IL
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Zip | 60126-4479
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Country | US
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Telephone | 163-094-1123
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANNIE C WANG
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Credential | DC
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Telephone | 16309411234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 38008961
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License Number State | IL
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