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NPI Code Detail

MEDICARE: MICHELLE LEE YOUNG LAC

MEDICARE: MICHELLE LEE YOUNG LAC
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
1171100000XAcupuncturist198-000808IL

General Provider Information

NPI Number : 1932352325
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE LEE YOUNG LAC
Provider Business Mailing Address
First Line : 1630 W DIVISION ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-3808
Country : US
Telephone Number : 773-276-2801
Fax Number :
Provider Business Practice Location Address
First Line : 1630 W DIVISION ST
Second Line :
City : CHICAGO
State : IL
Zip : 60622-3808
Country : US
Telephone Number : 773-276-2801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2008
Last Update Date : 03/29/2022

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