# ANCIENT HEALING ORIENTAL MEDICINE CLINIC S.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ancient Healing OMC s.c.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306073747
- **Authorized official:** MRS. WIOLETTA BORECKA-KOLCAN MD, OMD, L.AC. (PRESIDENT)
- **Authorized official phone:** (773) 562-0734

## Contact information

- **Practice address:** 987 OAK KNOLL DR., LAKE FOREST, IL 60045-2635
- **Practice address phone:** (847) 735-9609
- **Practice address fax:** (847) 235-2439
- **Mailing address:** 987 OAK KNOLL DR, LAKE FOREST, IL 60045-2635
- **Mailing address phone:** (847) 735-9609
- **Mailing address fax:** (847) 235-2439

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 03801172 | IL | — |
| 261Q00000X | Clinic/Center | 198.000814 | IL | Yes |
| 261Q00000X | Clinic/Center | 198000814 | IL | — |

## Other

- **Enumeration date:** 06/11/2009
- **Last updated:** 01/25/2011