MEDICARE: MERIDIAN & MYRRH ACUPUNCTURE AND WELLNESS, 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	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1912884636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERIDIAN & MYRRH ACUPUNCTURE AND WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	15 WALKER AVE
Second Line	:
City	:	CLARENDON HILLS
State	:	IL
Zip	:	60514-1338
Country	:	US
Telephone Number	:	320-420-5040
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 WALKER AVE
Second Line	:
City	:	CLARENDON HILLS
State	:	IL
Zip	:	60514-1338
Country	:	US
Telephone Number	:	320-420-5040
Fax Number	:

Authorized Official
Title or Position	:	OWNER, ACUPUNCTURIST
Name	:	KARA HAAKONSON
Credential	:	DACCHM, LAC
Telephone Number	:	320-420-5040

Provider Enumeration Date	:	08/18/2025
Last Update Date	:	08/18/2025

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