Provider Demographics
NPI:1952753220
Name:WISDOM OF HEALTH
Entity Type:Organization
Organization Name:WISDOM OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:312-343-0503
Mailing Address - Street 1:500 N DEARBORN ST
Mailing Address - Street 2:SUITE 1012
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 N DEARBORN ST
Practice Address - Street 2:SUITE 1012
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-3300
Practice Address - Country:US
Practice Address - Phone:312-343-0503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198001301171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty