Provider Demographics
NPI:1316530272
Name:HURH, JEAN (LAC, MATOM, DIPLOM)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:HURH
Suffix:
Gender:F
Credentials:LAC, MATOM, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 E GOLF RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4008
Mailing Address - Country:US
Mailing Address - Phone:847-427-5678
Mailing Address - Fax:847-545-1237
Practice Address - Street 1:342 E GOLF RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4008
Practice Address - Country:US
Practice Address - Phone:847-427-5678
Practice Address - Fax:847-545-1237
Is Sole Proprietor?:No
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198001551171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist