Organization
ENLIGHTEN HOLISTIC MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MULLEN DESIERTO L.AC. (LICENSED ACUPUNCTURIST)
(773) 682-7124
Entity
Organization
Contact information
Practice address
5330 W DEVON AVE, SUITE 5, CHICAGO, IL 60646-4148
(773) 682-7124
Mailing address
5330 W DEVON AVE, SUITE 5, CHICAGO, IL 60646-4148
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198.001110
IL
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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