Individual
KARYN BETH FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
2225 W NORTH AVE, CHICAGO, IL 60647-5429
(312) 203-2667
Mailing address
815 GREY AVE, EVANSTON, IL 60202-1508
(312) 203-2667
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198.000582
IL
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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