MEDICARE: AVONDALE ACUPUNCTURE 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	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1659235877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVONDALE ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	3958 N AVONDALE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-6245
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3958 N AVONDALE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-6245
Country	:	US
Telephone Number	:	240-603-8791
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF ACUPUNCTURE
Name	:	CHRISTIAN VILLACRES
Credential	:	DAOM
Telephone Number	:	240-603-8791

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “AVONDALE ACUPUNCTURE LLC ” Practice Location

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