Provider Demographics
NPI:1699938670
Name:ZHUANG, BO (ACUPUNCTURIST)
Entity type:Individual
Prefix:MRS
First Name:BO
Middle Name:
Last Name:ZHUANG
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 FALCON POINT PL
Mailing Address - Street 2:
Mailing Address - City:ROCKTON
Mailing Address - State:IL
Mailing Address - Zip Code:61072-3302
Mailing Address - Country:US
Mailing Address - Phone:815-608-1000
Mailing Address - Fax:
Practice Address - Street 1:109 N ALPINE RD
Practice Address - Street 2:101
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-4901
Practice Address - Country:US
Practice Address - Phone:779-423-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198000709171100000X
IL198.000709171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist