MEDICARE: VICTORIA SOUS LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	198001313	IL

General Provider Information

NPI Number	:	1497104418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA SOUS LAC

Provider Business Mailing Address
First Line	:	259 E RAND RD STE 107
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-2184
Country	:	US
Telephone Number	:	224-307-4325
Fax Number	:	866-530-1169

Provider Business Practice Location Address
First Line	:	259 E RAND RD STE 107
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-2184
Country	:	US
Telephone Number	:	224-531-8518
Fax Number	:	866-530-1169

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2016
Last Update Date	:	03/06/2019

Similar Medicare Providers

1902753742 — JM SUPPLIES INC
Practice Location Address:

259 E RAND RD STE 205
MOUNT PROSPECT, IL
60056-2184

Practice Phone: 510-944-6583
Practice Fax:

1952448474 — DR. KATHY PAWLUSIEWICZ D.D.S.
Practice Location Address:

259 E RAND RD , SUITE 110
MOUNT PROSPECT, IL
60056-2184

Practice Phone: 847-890-4444
Practice Fax: 847-506-0148

1104013762 — DR. KAPIL VIJ DDS
Practice Location Address:

259 E RAND RD , #110
MOUNT PROSPECT, IL
60056-2184

Practice Phone: 847-321-9445
Practice Fax:

1629356241 — KAPIL VIJ DDS MS PC
Practice Location Address:

259 E RAND RD STE 110
MOUNT PROSPECT, IL
60056-2184

Practice Phone: 847-321-9445
Practice Fax:

1518522408 — BEST MEDICAL SUPPLY INC
Practice Location Address:

259 E RAND RD STE 209
MOUNT PROSPECT, IL
60056-2184

Practice Phone: 730-230-9101
Practice Fax: 630-231-1002

1376284067 — HEALING PARADISE ACUPUNCTURE
Practice Location Address:

259 E RAND RD STE 107
MOUNT PROSPECT, IL
60056-2184

Practice Phone: 224-307-4325
Practice Fax: 866-307-0289

Directions to “ VICTORIA SOUS LAC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.