Provider Demographics
NPI:1043640014
Name:YIN YANG WISDOM ACUPUNCTURE LLC
Entity type:Organization
Organization Name:YIN YANG WISDOM ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:773-620-9099
Mailing Address - Street 1:1300 W BELMONT AVE STE 407D
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3242
Mailing Address - Country:US
Mailing Address - Phone:773-620-9099
Mailing Address - Fax:
Practice Address - Street 1:1300 W BELMONT AVE STE 407D
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3242
Practice Address - Country:US
Practice Address - Phone:773-620-9099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198000949171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL198000949OtherLICENSE