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General NPI Number Information
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NPI Number | 1386292084
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Entity Type | Organization
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Legal Business Name | HEALING ACUPUNCTURE AND HERBS
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 3000 DUNDEE RD STE 402
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City | NORTHBROOK
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State | IL
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Zip | 60062-2436
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Country | US
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Telephone | 847-204-3406
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 DUNDEE RD STE 402
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City | NORTHBROOK
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State | IL
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Zip | 60062-2436
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Country | US
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Telephone | 847-204-3406
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Fax |
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Authorized Official
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Title or Position | AGENT
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Name | SOO CHUNG
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Credential |
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Telephone | 630-402-5397
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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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