MEDICARE: ENN HEALING ARTS PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1669337333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENN HEALING ARTS PLLC

Provider Business Mailing Address
First Line	:	805 GREENWOOD ST
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-6521
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 GREENWOOD ST
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-6521
Country	:	US
Telephone Number	:	224-420-7405
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MUTSUKO SUGITA
Credential	:
Telephone Number	:	224-420-7405

Provider Enumeration Date	:	12/16/2025
Last Update Date	:	12/16/2025

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