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General NPI Number Information
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NPI Number | 1013341296
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Entity Type | Organization
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Legal Business Name | INTEGRAL ALTERNATIVE MEDICINE PLLC
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Dates
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Enumeration Date | 08/24/2013
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 730 S. DEARBORN ST
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City | CHICAGO
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State | IL
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Zip | 60605-1838
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Country | US
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Telephone | 312-631-3095
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Fax |
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Provider Business Mailing Address
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Address Line | 730 S DEARBORN ST
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City | CHICAGO
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State | IL
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Zip | 60605-1838
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Country | US
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Telephone | 312-631-3095
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARIA CRISTINA TORRES MOORE
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Credential | MSOM, LAC
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Telephone | 847-337-8057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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