MEDICARE: HOLICARE

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	:	1790236438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLICARE

Provider Business Mailing Address
First Line	:	2131 S ARCHER AVE UNIT C
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-1809
Country	:	US
Telephone Number	:	312-842-0626
Fax Number	:

Provider Business Practice Location Address
First Line	:	2131 S ARCHER AVE UNIT C
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-1809
Country	:	US
Telephone Number	:	312-842-0626
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ANG LI
Credential	:
Telephone Number	:	312-842-0626

Provider Enumeration Date	:	10/18/2016
Last Update Date	:	10/18/2016

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Directions to “HOLICARE ” Practice Location

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