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Organization

AWAKEN BLOSSOM FOUNDATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MILDRED ABONCE LMT (VICE-PRESIDENT)
(708) 613-5690
Entity
Organization

Contact information

Practice address
6142 ROOSEVELT RD # 101, OAK PARK, IL 60304-2311
(708) 613-5690
Mailing address
6142 ROOSEVELT RD # 101, OAK PARK, IL 60304-2311
(708) 613-5690

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198000100
IL
174400000X
Specialist
227004827
IL
174400000X
Specialist
227007446
IL

Other

Enumeration date
11/22/2014
Last updated
11/22/2014
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