MEDICARE: KRISTIN EISENSCHMID

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	173C00000X	Reflexologist	198.001600	IL
2	171100000X	Acupuncturist	198.001600	IL

General Provider Information

NPI Number	:	1851032247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN EISENSCHMID

Provider Business Mailing Address
First Line	:	5125 BLODGETT AVE APT 211
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-5042
Country	:	US
Telephone Number	:	267-210-8142
Fax Number	:

Provider Business Practice Location Address
First Line	:	770 N LA SALLE DR STE 800
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-5234
Country	:	US
Telephone Number	:	312-321-0004
Fax Number	:

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

Provider Enumeration Date	:	04/07/2022
Last Update Date	:	04/07/2022

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Directions to “ KRISTIN EISENSCHMID ” Practice Location

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