Provider Demographics
NPI:1447585740
Name:HANDA, AMIE SHIMMEL (DC,LAC)
Entity Type:Individual
Prefix:DR
First Name:AMIE
Middle Name:SHIMMEL
Last Name:HANDA
Suffix:
Gender:F
Credentials:DC,LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E SUPERIOR ST
Mailing Address - Street 2:SUITE 307
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2507
Mailing Address - Country:US
Mailing Address - Phone:312-664-8376
Mailing Address - Fax:312-664-8417
Practice Address - Street 1:1 E SUPERIOR ST
Practice Address - Street 2:SUITE 307
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2507
Practice Address - Country:US
Practice Address - Phone:312-664-8376
Practice Address - Fax:312-664-8417
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198001361171100000X
IL038006395111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist