Organization
BRIGHT SHEN ACUPUNCTURE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KINGA VAN BRUNT LAC. (FOUNDER)
(847) 648-7990
Entity
Organization
Contact information
Practice address
142 S GARY AVE STE 111, BLOOMINGDALE, IL 60108-2226
(847) 648-7990
Mailing address
1808 MARYLAND DR, ELK GROVE VILLAGE, IL 60007-2734
(847) 648-7990
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15661281
CAQH
IL
01
—
19800014
IDFPR
IL
Enumeration date
01/29/2024
Last updated
01/29/2024
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