Individual
KHADIJAH KYSIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1509 S STATE ST, CHICAGO, IL 60605-2804
(312) 344-1384
(312) 344-1457
Mailing address
1509 S STATE ST, CHICAGO, IL 60605-2804
(312) 344-1384
(312) 344-1457
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198001115
IL
Other
Enumeration date
12/28/2015
Last updated
12/28/2015
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