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General NPI Number Information
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NPI Number | 1598825556
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE HEALTH GROUP LLC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 2209 W NORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60647
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Country | US
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Telephone | 773-227-9150
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Fax | 773-227-9160
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Provider Business Mailing Address
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Address Line | 2209 W NORTH AVE
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City | CHICAGO
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State | IL
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Zip | 60647-6084
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Country | US
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Telephone | 773-227-9150
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Fax | 773-227-9160
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. TIMOTHY IN JAE SUH
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Credential | DAOM, L. AC.
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Telephone | 773-227-9150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.016665
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227.008514
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 198.000610
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License Number State | IL
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