Provider Demographics
NPI:1609957810
Name:CHICAGO FIRST CHINESE ACUPUNCTURE & MEDICAL CENTER
Entity Type:Organization
Organization Name:CHICAGO FIRST CHINESE ACUPUNCTURE & MEDICAL CENTER
Other - Org Name:CHGO 1ST CHINESE ACU-MED CTR.
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WEN
Authorized Official - Middle Name:
Authorized Official - Last Name:XUAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-674-1988
Mailing Address - Street 1:1098 S. MILWAUKEE AVE
Mailing Address - Street 2:SUITE 107B
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-6377
Mailing Address - Country:US
Mailing Address - Phone:847-297-6883
Mailing Address - Fax:847-297-6885
Practice Address - Street 1:2159 S CHINA PL FL 2
Practice Address - Street 2:SUITE B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-1536
Practice Address - Country:US
Practice Address - Phone:312-674-1988
Practice Address - Fax:312-674-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty