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Contact Information

AWAKEN BLOSSOM FOUNDATION
6142 ROOSEVELT RD # 101
OAK PARK, IL60304-2311
 Phone: 708-613-5690
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
 

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for AWAKEN BLOSSOM FOUNDATION · (Female)

NPI # 1659778421
Status Active
Credentials
Entity Individual
Enumeration date 11/22/2014
Last updated 11/22/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • IL License # 198000100
  • IL License # 227004827
  • IL License # 227007446
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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