Provider Demographics
NPI:1336217363
Name:HEALING TOUCH CHIROPRACTIC P C
Entity Type:Organization
Organization Name:HEALING TOUCH CHIROPRACTIC P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:YOON
Authorized Official - Last Name:SONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-755-0400
Mailing Address - Street 1:8 GOLF CTR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-4910
Mailing Address - Country:US
Mailing Address - Phone:847-755-0400
Mailing Address - Fax:847-755-0414
Practice Address - Street 1:8 GOLF CTR
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-4910
Practice Address - Country:US
Practice Address - Phone:847-755-0400
Practice Address - Fax:847-755-0414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01623415OtherBLUE CROSS BLUE SHIELD
543120Medicare PIN
U78011Medicare UPIN