Provider Demographics
NPI:1548707987
Name:EASTERN HEALING TRADITIONS
Entity type:Organization
Organization Name:EASTERN HEALING TRADITIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KUMARAVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NATARAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:224-541-0022
Mailing Address - Street 1:34121 N US HIGHWAY 45
Mailing Address - Street 2:SUITE 218
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-1768
Mailing Address - Country:US
Mailing Address - Phone:224-541-0022
Mailing Address - Fax:844-899-4225
Practice Address - Street 1:34121 N US HIGHWAY 45
Practice Address - Street 2:SUITE 218
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1768
Practice Address - Country:US
Practice Address - Phone:224-541-0022
Practice Address - Fax:844-899-4225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.00102171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty