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General NPI Number Information
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NPI Number | 1184413270
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Entity Type | Individual
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Provider Name | PRINCESS BURNETT ND, DIPL. OM, LAC
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Gender | Female
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 2023 RIDGE RD
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City | HOMEWOOD
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State | IL
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Zip | 60430-1749
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Country | US
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Telephone | 708-889-5088
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Fax |
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Provider Business Mailing Address
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Address Line | 1127 E 163RD ST
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-2518
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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 |
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State | IL
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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 | 198.001672
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License Number State | IL
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