Provider Demographics
NPI:1457481624
Name:ZHAI, NA (PHD, OMD)
Entity Type:Individual
Prefix:DR
First Name:NA
Middle Name:
Last Name:ZHAI
Suffix:
Gender:F
Credentials:PHD, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 W WHITE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-7421
Mailing Address - Country:US
Mailing Address - Phone:217-698-6259
Mailing Address - Fax:217-698-6265
Practice Address - Street 1:2309 W WHITE OAKS DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-7421
Practice Address - Country:US
Practice Address - Phone:217-698-6259
Practice Address - Fax:217-698-6265
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198-000171171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist