Provider Demographics
NPI:1497080444
Name:PICKERING, HELEN ROSE (LAC)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:ROSE
Last Name:PICKERING
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 CHURCH ST STE 505
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4581
Mailing Address - Country:US
Mailing Address - Phone:847-864-6464
Mailing Address - Fax:
Practice Address - Street 1:636 CHURCH ST STE 505
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4581
Practice Address - Country:US
Practice Address - Phone:847-864-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000502171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist