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Contact Information

BODHI & SAGE, LLC
1525 E 53RD ST STE 808
CHICAGO, IL60615-4583
 Phone: 312-403-1853
 Fax: 773-947-0084
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
Indicates primary specialty

NPI Profile & details for BODHI & SAGE, LLC

NPI # 1902391360
LBN Legal business name BODHI & SAGE, LLC
Authorized official ROGER FONG - (FOUNDER & CLINIC DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 06/28/2018
Last updated 06/28/2018 - About 8 years ago
Identifiers
IL License # 198001289
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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