MEDICARE: ALTERNATIVE HEALTH GROUP LLC

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	103TP2701X	Group Psychotherapy Psychologist
2	225100000X	Physical Therapist	070.016665	IL
3	225700000X	Massage Therapist	227.008514	IL
4	171100000X	Acupuncturist	198.000610	IL

General Provider Information

NPI Number	:	1598825556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTERNATIVE HEALTH GROUP LLC

Provider Business Mailing Address
First Line	:	2209 W NORTH AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-6084
Country	:	US
Telephone Number	:	773-227-9150
Fax Number	:	773-227-9160

Provider Business Practice Location Address
First Line	:	2209 W NORTH AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647
Country	:	US
Telephone Number	:	773-227-9150
Fax Number	:	773-227-9160

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. TIMOTHY IN JAE SUH
Credential	:	DAOM, L. AC.
Telephone Number	:	773-227-9150

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	03/30/2023

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