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General NPI Number Information
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NPI Number | 1417363961
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Entity Type | Organization
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Legal Business Name | TRIGGER POINT TREATMENT CENTER OF CHICAGO LLC
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Dates
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Enumeration Date | 07/05/2014
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Last Update Date | 07/05/2014
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Provider Practice Location Address
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Address Line | 1150 N STATE ST C315
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City | CHICAGO
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State | IL
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Zip | 60610-7481
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Country | US
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Telephone | 773-263-3491
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 N STATE ST C315
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City | CHICAGO
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State | IL
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Zip | 60610-7481
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Country | US
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Telephone | 773-263-3491
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Fax |
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Authorized Official
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Title or Position | OWNER/TRIGGER POINT THERAPIST
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Name | JENNIFER LIU
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Credential | CMTPT, LMT
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Telephone | 773-263-3491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 227.016025
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License Number State | IL
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