Provider Demographics
NPI:1629407499
Name:MICHALAK, CHRISTOPHER J (LAC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:J
Last Name:MICHALAK
Suffix:
Gender:M
Credentials:LAC
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Mailing Address - Street 1:3817 1/2 N GREENVIEW AVE
Mailing Address - Street 2:3E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2753
Mailing Address - Country:US
Mailing Address - Phone:315-247-9722
Mailing Address - Fax:773-254-8944
Practice Address - Street 1:735 W 35TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4481
Practice Address - Country:US
Practice Address - Phone:313-247-9722
Practice Address - Fax:773-254-8944
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL198.001349171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist