Provider Demographics
NPI:1669848230
Name:TAKACAT LLC
Entity Type:Organization
Organization Name:TAKACAT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:TAKAKO
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKAYANAGI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:312-307-1321
Mailing Address - Street 1:2864 S QUINN ST
Mailing Address - Street 2:ATP 2F
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-5921
Mailing Address - Country:US
Mailing Address - Phone:312-307-1321
Mailing Address - Fax:
Practice Address - Street 1:118 N CLINTON ST
Practice Address - Street 2:STE 100-14
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-2386
Practice Address - Country:US
Practice Address - Phone:312-473-6521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198000463171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty