MEDICARE: KATHLEEN M LOVE MS, 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
1	171100000X	Acupuncturist	198.000653	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	198.000653	OTHER	IL	STATE OF ILLINOIS

General Provider Information

NPI Number	:	1740627439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN M LOVE MS, L.AC.

Provider Business Mailing Address
First Line	:	664 W HUBBARD ST FL 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-5509
Country	:	US
Telephone Number	:	773-389-3320
Fax Number	:

Provider Business Practice Location Address
First Line	:	664 W HUBBARD ST FL 2
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-5509
Country	:	US
Telephone Number	:	773-389-3320
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2013
Last Update Date	:	09/23/2021

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