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General NPI Number Information
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NPI Number | 1053938571
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Entity Type | Individual
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Provider Name | ANNA MARIA DEGRASSI-KALKIS L AC, DIPL OM
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Gender | Female
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Dates
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Enumeration Date | 06/30/2020
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Last Update Date | 06/30/2020
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Provider Practice Location Address
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Address Line | 18700 WOLF RD STE 211
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City | MOKENA
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State | IL
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Zip | 60448-8603
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Country | US
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Telephone | 815-955-2893
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Fax |
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Provider Business Mailing Address
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Address Line | 20801 S HUMBOLDT DR
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City | FRANKFORT
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State | IL
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Zip | 60423-9079
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Country | US
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Telephone | 815-955-2893
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 198.000654
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License Number State | IL
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