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General NPI Number Information
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NPI Number | 1821473521
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Entity Type | Organization
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Legal Business Name | WESTYO ACUPUNCTURE & HERB
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 07/23/2015
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Provider Practice Location Address
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Address Line | 2622 W PETERSON AVE SUITE 1
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City | CHICAGO
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State | IL
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Zip | 60659-4039
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Country | US
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Telephone | 773-809-0528
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Fax |
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Provider Business Mailing Address
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Address Line | 2622 W PETERSON AVE SUITE 1
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City | CHICAGO
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State | IL
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Zip | 60659-4039
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Country | US
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Telephone | 773-809-0528
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WEIYAN LIU
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Credential |
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Telephone | 773-809-0528
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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 | 198.000851
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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 | 038.012324
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License Number State | IL
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