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NPI Code Detail

MEDICARE: BENEDICTO UY JR. L.AC

MEDICARE: BENEDICTO UY JR. L.AC
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
1171100000XAcupuncturist198001501IL

General Provider Information

NPI Number : 1609341387
Entity Type Code : Individual
Provider Name (Legal Business Name) : BENEDICTO UY JR. L.AC
Provider Business Mailing Address
First Line : 1314 W ARGYLE ST APT 1
Second Line :
City : CHICAGO
State : IL
Zip : 60640-4057
Country : US
Telephone Number : 847-387-2940
Fax Number :
Provider Business Practice Location Address
First Line : 17 N WABASH AVE STE 470
Second Line :
City : CHICAGO
State : IL
Zip : 60602-4818
Country : US
Telephone Number : 312-508-3955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/09/2018
Last Update Date : 08/11/2020

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