Organization
LEESHERBSLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GUANGQIAN LI LAC (OWNER)
(773) 895-1188
Entity
Organization
Contact information
Practice address
4759 N KEDZIE AVE STE 104, CHICAGO, IL 60625-4420
(773) 895-1188
Mailing address
4759 N KEDZIE AVE STE 104, CHICAGO, IL 60625-4420
(773) 895-1188
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198.001330
IL
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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