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General NPI Number Information
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NPI Number | 1811444789
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Entity Type | Organization
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Legal Business Name | GEHLHAUSEN ACUPUNCTURE & HERBAL MEDICINE LLC
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 01/27/2017
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Provider Practice Location Address
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Address Line | 1776 LEGACY CIR SUITE 102
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City | NAPERVILLE
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State | IL
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Zip | 60563-1642
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Country | US
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Telephone | 630-210-4912
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 465
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City | GENEVA
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State | IL
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Zip | 60134-0465
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Country | US
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Telephone | 630-210-4912
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANA GEHLHAUSEN
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Credential | L.AC.
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Telephone | 630-210-4912
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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 | 198.001290
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License Number State | IL
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