Provider Demographics
NPI:1427421775
Name:LK ACUPUNCTURE LLC
Entity type:Organization
Organization Name:LK ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KELCHAK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:219-617-4538
Mailing Address - Street 1:423 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-2305
Mailing Address - Country:US
Mailing Address - Phone:219-617-4538
Mailing Address - Fax:
Practice Address - Street 1:91 BANKVIEW DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-1861
Practice Address - Country:US
Practice Address - Phone:219-617-4538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198001261171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty