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General NPI Number Information
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NPI Number | 1679746739
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Entity Type | Organization
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Legal Business Name | LAUREL HEALTH CENTER, INC.
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 3348 W 95TH ST
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-2236
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Country | US
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Telephone | 708-422-1512
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Fax | 708-422-1417
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Provider Business Mailing Address
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Address Line | 122 HIDDENVIEW DR
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City | WESTMONT
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State | IL
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Zip | 60559-2327
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Country | US
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Telephone | 708-422-1512
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Fax | 708-422-1417
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LI-MEI KU
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Credential | D.C.
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Telephone | 708-422-1512
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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 | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IL
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