Provider Demographics
NPI:1316244056
Name:HEALING FOUNDATIONS, LLC
Entity type:Organization
Organization Name:HEALING FOUNDATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEMPERLE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, MSOM
Authorized Official - Phone:773-880-9939
Mailing Address - Street 1:2112 W BELMONT AVE
Mailing Address - Street 2:STOREFRONT
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6414
Mailing Address - Country:US
Mailing Address - Phone:773-880-9939
Mailing Address - Fax:773-880-9916
Practice Address - Street 1:2112 W BELMONT AVE
Practice Address - Street 2:STOREFRONT
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6414
Practice Address - Country:US
Practice Address - Phone:773-880-9939
Practice Address - Fax:773-880-9916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-15
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
IL198.000752171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty