Provider Demographics
NPI:1699319996
Name:LI, XIUZHEN (DC)
Entity type:Individual
Prefix:
First Name:XIUZHEN
Middle Name:
Last Name:LI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 W 26TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4099
Mailing Address - Country:US
Mailing Address - Phone:312-763-6192
Mailing Address - Fax:312-277-3533
Practice Address - Street 1:222 W 26TH ST STE A
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4099
Practice Address - Country:US
Practice Address - Phone:312-763-6192
Practice Address - Fax:312-277-3533
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-30
Last Update Date:2024-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038013130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor