Provider Demographics
NPI:1538298948
Name:DRAGON'S LIFE SYSTEMS
Entity Type:Organization
Organization Name:DRAGON'S LIFE SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHENGLI
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:630-435-5858
Mailing Address - Street 1:1040 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2877
Mailing Address - Country:US
Mailing Address - Phone:630-435-5858
Mailing Address - Fax:630-435-5548
Practice Address - Street 1:1040 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2877
Practice Address - Country:US
Practice Address - Phone:630-435-5858
Practice Address - Fax:630-435-5548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL98-000266171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty