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General NPI Number Information
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NPI Number | 1336371426
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Entity Type | Individual
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Provider Name | DONGHI SHIN ACUPUNCTURIST
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Gender | Female
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 08/21/2009
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Provider Practice Location Address
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Address Line | 523 S BARTLETT RD
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City | STREAMWOOD
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State | IL
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Zip | 60107-1309
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Country | US
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Telephone | 630-372-7372
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Fax |
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Provider Business Mailing Address
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Address Line | 4260 CENTRAL RD APT 301
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City | GLENVIEW
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State | IL
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Zip | 60025-5617
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Country | US
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Telephone | 847-894-0522
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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 | 198000570
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License Number State | IL
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