Individual
MRS. KINGA VAN BRUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC.
Contact information
Practice address
1158 S ROSELLE RD, SCHAUMBURG, IL 60193-4072
(847) 301-7305
Mailing address
1808 MARYLAND DR, ELK GROVE VILLAGE, IL 60007-2734
(773) 844-6416
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198000914
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198000914
ACUPUNCTURE LICENSE NUMBER
IL
Enumeration date
03/04/2021
Last updated
03/04/2021
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