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Organization
DONGWON ACUPUNCTURE CORP
Active
Organization
DONGWON ACUPUNCTURE CORP
Active
Other names
Richard Kim
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD KIM L.AC (CLINICAL DIRECTOR)
(224) 938-9521
Entity
Organization
Contact information
Practice address
1600 DEMPSTER ST STE 206, PARK RIDGE, IL 60068-1172
(224) 938-9521
Mailing address
1600 DEMPSTER ST STE 206, PARK RIDGE, IL 60068-1172
(224) 410-7898
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
261QH0100X
Health Service Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063005247982
MADICAID
IL
Enumeration date
06/24/2021
Last updated
06/29/2021
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