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General NPI Number Information
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NPI Number | 1982139101
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Entity Type | Organization
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Legal Business Name | HERB AND OHM, LLC
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Dates
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Enumeration Date | 04/25/2017
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Last Update Date | 04/25/2017
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Provider Practice Location Address
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Address Line | 205 W RANDOLPH ST STE 1800
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City | CHICAGO
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State | IL
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Zip | 60606-1820
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Country | US
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Telephone | 312-757-1882
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Fax |
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Provider Business Mailing Address
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Address Line | 936 W MADISON ST APT 3E
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City | CHICAGO
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State | IL
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Zip | 60607-2621
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Country | US
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Telephone | 312-757-1882
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY WOLF
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Credential | DACM, L.AC.
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Telephone | 312-757-1882
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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 | 248.001134
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License Number State | IL
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