MEDICARE: CHICAGO FIRST CHINESE ACUPUNCTURE & MEDICAL CENTER

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		IL

General Provider Information

NPI Number	:	1609957810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO FIRST CHINESE ACUPUNCTURE & MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1098 S. MILWAUKEE AVE
Second Line	:	SUITE 107B
City	:	WHEELING
State	:	IL
Zip	:	60090-6377
Country	:	US
Telephone Number	:	847-297-6883
Fax Number	:	847-297-6885

Provider Business Practice Location Address
First Line	:	2159 S CHINA PL FL 2
Second Line	:	SUITE B
City	:	CHICAGO
State	:	IL
Zip	:	60616-1536
Country	:	US
Telephone Number	:	312-674-1988
Fax Number	:	312-674-1988

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. WEN XUAN
Credential	:	M.D.
Telephone Number	:	312-674-1988

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	08/22/2020

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