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General NPI Number Information
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NPI Number | 1740686492
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Entity Type | Individual
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Provider Name | LANA MOSHKOVICH L.AC
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Gender | Female
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Dates
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Enumeration Date | 11/07/2014
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Last Update Date | 08/13/2018
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Provider Practice Location Address
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Address Line | 1500 SHERMER RD STE LL29
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City | NORTHBROOK
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State | IL
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Zip | 60062
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Country | US
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Telephone | 847-715-9044
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Fax | 847-564-2100
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Provider Business Mailing Address
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Address Line | 905 TAMER LN
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City | GLENVIEW
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State | IL
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Zip | 60025-3768
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Country | US
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Telephone | 847-508-1470
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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 | 198001239
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License Number State | IL
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