Provider Demographics
NPI:1770827040
Name:HEALING ARTS OF ORIENTAL MEDICINE
Entity Type:Organization
Organization Name:HEALING ARTS OF ORIENTAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANATOLIY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:847-845-4090
Mailing Address - Street 1:405 LAKE COOK RD
Mailing Address - Street 2:STE 211
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4993
Mailing Address - Country:US
Mailing Address - Phone:847-845-4090
Mailing Address - Fax:
Practice Address - Street 1:405 LAKE COOK RD
Practice Address - Street 2:STE 211
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4993
Practice Address - Country:US
Practice Address - Phone:847-845-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000621171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty