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General NPI Number Information
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NPI Number | 1427421775
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Entity Type | Organization
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Legal Business Name | LK ACUPUNCTURE LLC
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Dates
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Enumeration Date | 11/09/2015
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 91 BANKVIEW DR
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City | FRANKFORT
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State | IL
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Zip | 60423-1861
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Country | US
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Telephone | 219-617-4538
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Fax |
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Provider Business Mailing Address
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Address Line | 423 S 4TH ST
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City | CHESTERTON
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State | IN
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Zip | 46304-2305
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Country | US
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Telephone | 219-617-4538
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Fax |
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Authorized Official
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Title or Position | LICENSED ACUPUNCTURIST
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Name | MS. LIZABETH KELCHAK
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Credential | L.AC
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Telephone | 219-617-4538
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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 | 198001261
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License Number State | IL
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