Provider Demographics
NPI:1912449257
Name:GUO, SHENG (NCCAOM)
Entity type:Individual
Prefix:
First Name:SHENG
Middle Name:
Last Name:GUO
Suffix:
Gender:M
Credentials:NCCAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 W IRVING PARK RD
Mailing Address - Street 2:APT #2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-3406
Mailing Address - Country:US
Mailing Address - Phone:630-333-2018
Mailing Address - Fax:
Practice Address - Street 1:3110 W IRVING PARK RD
Practice Address - Street 2:APT #2
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-3406
Practice Address - Country:US
Practice Address - Phone:630-333-2018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001333171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL164146OtherNCCAOM