Provider Demographics
NPI:1376874180
Name:ONE COMMUNITY ACUPUNCTURE CENTER, INC
Entity Type:Organization
Organization Name:ONE COMMUNITY ACUPUNCTURE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:E
Authorized Official - Last Name:CARPINTERO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:630-837-4241
Mailing Address - Street 1:342 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:342 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4423
Practice Address - Country:US
Practice Address - Phone:630-837-4241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-18
Last Update Date:2010-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198000645171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty