Provider Demographics
NPI:1215327226
Name:LANG, NANN (LAC)
Entity type:Individual
Prefix:MR
First Name:NANN
Middle Name:
Last Name:LANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 N WOOD DALE RD
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-1531
Mailing Address - Country:US
Mailing Address - Phone:630-422-5232
Mailing Address - Fax:630-635-6689
Practice Address - Street 1:331 N WOOD DALE RD
Practice Address - Street 2:
Practice Address - City:WOOD DALE
Practice Address - State:IL
Practice Address - Zip Code:60191-1531
Practice Address - Country:US
Practice Address - Phone:630-422-5232
Practice Address - Fax:630-635-6689
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001197171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist