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General NPI Number Information
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NPI Number | 1124627583
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Entity Type | Organization
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Legal Business Name | KATE WARGIN LAC CHARTERED
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Dates
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Enumeration Date | 10/17/2020
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Last Update Date | 10/17/2020
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Provider Practice Location Address
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Address Line | 757 W DIVERSEY PKWY
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City | CHICAGO
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State | IL
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Zip | 60614-6505
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Country | US
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Telephone | 414-544-4775
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Fax | 312-262-6364
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Provider Business Mailing Address
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Address Line | 757 W DIVERSEY PKWY
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City | CHICAGO
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State | IL
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Zip | 60614-6505
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Country | US
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Telephone | 414-544-4775
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Fax | 312-262-6364
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MS. KATE WARGIN
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Credential | L.AC.
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Telephone | 414-544-4775
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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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