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General NPI Number Information
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NPI Number | 1093604803
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Entity Type | Organization
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Legal Business Name | IRIS ACUPUNCTURE LLC
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 1151 W WASHINGTON BLVD UNIT 103
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City | CHICAGO
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State | IL
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Zip | 60607-2002
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Country | US
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Telephone | 414-627-9933
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Fax |
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Provider Business Mailing Address
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Address Line | 1151 W WASHINGTON BLVD UNIT 103
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City | CHICAGO
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State | IL
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Zip | 60607-2002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | TESSA HERMANN
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Credential |
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Telephone | 414-627-9933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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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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