Provider Demographics
NPI:1295111680
Name:LING, XIA
Entity type:Individual
Prefix:
First Name:XIA
Middle Name:
Last Name:LING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 S SANGAMON ST
Mailing Address - Street 2:UNIT 714
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-2239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1524 S SANGAMON ST
Practice Address - Street 2:UNIT 714
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-2239
Practice Address - Country:US
Practice Address - Phone:312-493-4822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist