Provider Demographics
NPI:1386842946
Name:SUH ALTERNATIVE HEALTH AND PAIN CLINIC
Entity Type:Organization
Organization Name:SUH ALTERNATIVE HEALTH AND PAIN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DUCKIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-364-2424
Mailing Address - Street 1:1600 W GOLF RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4004
Mailing Address - Country:US
Mailing Address - Phone:847-364-2424
Mailing Address - Fax:847-364-2423
Practice Address - Street 1:1600 W GOLF RD
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056
Practice Address - Country:US
Practice Address - Phone:847-364-2424
Practice Address - Fax:847-364-2423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007998111N00000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty