Provider Demographics
NPI:1184424038
Name:LEE FERRENBACH
Entity type:Organization
Organization Name:LEE FERRENBACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ACUPUNTURIST
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-305-6554
Mailing Address - Street 1:1361 W GREENLEAF AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-5804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1361 W GREENLEAF AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-5804
Practice Address - Country:US
Practice Address - Phone:314-305-6554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty