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General NPI Number Information
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NPI Number | 1881589927
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Entity Type | Organization
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Legal Business Name | KASEY SPORTS ACUPUNCTURE PLLC
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 3620 N LINCOLN AVE
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City | CHICAGO
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State | IL
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Zip | 60613-3516
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Country | US
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Telephone | 312-877-5881
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Fax |
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Provider Business Mailing Address
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Address Line | 2848 W BARRY AVE APT 1
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City | CHICAGO
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State | IL
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Zip | 60618-8487
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | KASEY MCKENNEY
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Credential | L.AC
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Telephone | 317-496-7338
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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 |
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