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General NPI Number Information
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NPI Number | 1497219349
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Entity Type | Individual
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Provider Name | CADY ELREDY LAC
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Gender | Female
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Dates
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Enumeration Date | 01/24/2019
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Last Update Date | 07/07/2019
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Provider Practice Location Address
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Address Line | 3234 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60647-2594
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Country | US
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Telephone | 773-466-9882
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Fax |
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Provider Business Mailing Address
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Address Line | 922 NORTH BLVD APT 408
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City | OAK PARK
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State | IL
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Zip | 60301-1242
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Country | US
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Telephone | 469-777-1133
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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 | 198001409
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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 | 198.001409
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License Number State | IL
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