# JADE DRAGON ACUPUNCTURE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215707310
- **Authorized official:** JENI USWAJESDAKUL LAC (OWNER)
- **Authorized official phone:** (312) 870-0512

## Contact information

- **Practice address:** 4801 W PETERSON AVE STE 305, CHICAGO, IL 60646-5726
- **Practice address phone:** (312) 870-0512
- **Mailing address:** 4801 W PETERSON AVE STE 305, CHICAGO, IL 60646-5726

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/09/2024
- **Last updated:** 01/09/2024