Provider Demographics
NPI:1437307022
Name:CHIANG, MING JIE (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MS
First Name:MING JIE
Middle Name:
Last Name:CHIANG
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 BURTON AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-4611
Mailing Address - Country:US
Mailing Address - Phone:847-433-2835
Mailing Address - Fax:
Practice Address - Street 1:2611 EASTWOOD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1517
Practice Address - Country:US
Practice Address - Phone:847-712-2835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198000540171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist