Provider Demographics
NPI:1093364598
Name:ZHANG, XIN (LAC)
Entity Type:Individual
Prefix:
First Name:XIN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 HARVEST DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-3142
Mailing Address - Country:US
Mailing Address - Phone:630-506-8963
Mailing Address - Fax:
Practice Address - Street 1:229 W OGDEN AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3047
Practice Address - Country:US
Practice Address - Phone:630-506-8369
Practice Address - Fax:888-528-3869
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-06
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198001487171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty