Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | IL |
NPI | 1003916933 |
---|---|
Provider Name | Meiling Qian |
First Address | Chicago, IL 60609-2113 |
Second Address | Chicago, IL 60616-3135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01632650 | BLUE SHIELD OF IL (01) | IL |