Provider Demographics
NPI:1710526330
Name:YIN AND TONIC, LLC
Entity Type:Organization
Organization Name:YIN AND TONIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIPHANT
Authorized Official - Suffix:
Authorized Official - Credentials:DACM
Authorized Official - Phone:312-869-9654
Mailing Address - Street 1:4770 N LINCOLN AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2092
Mailing Address - Country:US
Mailing Address - Phone:312-869-9654
Mailing Address - Fax:
Practice Address - Street 1:4770 N LINCOLN AVE STE 212
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2092
Practice Address - Country:US
Practice Address - Phone:312-869-9654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-30
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty