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General NPI Number Information
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NPI Number | 1861985590
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Entity Type | Organization
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Legal Business Name | HOLISTIC HEALTH CARE CENTERS, LLC
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 06/07/2018
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Provider Practice Location Address
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Address Line | 3033 OGDEN AVE STE 302
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City | LISLE
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State | IL
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Zip | 60532-1976
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Country | US
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Telephone | 847-571-5455
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Fax |
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Provider Business Mailing Address
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Address Line | 3033 OGDEN AVE STE 302
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City | LISLE
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State | IL
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Zip | 60532-1976
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Country | US
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Telephone | 847-571-5455
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Fax |
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Authorized Official
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Title or Position | OWNER, ACUPUNCTURIST
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Name | KIMBERLY LEUPOLD
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Credential | L.AC.
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Telephone | 847-571-5455
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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 | 198.001129
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License Number State | IL
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