Individual provider Active NPI

Michael Oliphant, L.AC.

  • Acupuncturist
  • Chicago, IL
National Provider Identifier
1366702953
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
198000983 Issued in IL
Practice address
4770 N Lincoln Ave Ste 212
Chicago, IL 60625-2092
Phone
(312) 869-9654
NPI assigned
May 17, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 198000983 IL Primary

Addresses

Primary practice location

4770 N Lincoln Ave Ste 212
Chicago, IL 60625-2092

Mailing address

4770 N Lincoln Ave Ste 212
Chicago, IL 60625-2092
Phone (312) 869-9654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
198000983ILMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Yin and Tonic, LLC Acupuncturist CurrentSince Apr 30, 2023 Accepting new patients

Locations

4770 N Lincoln Ave
Ste 212
Chicago, IL 60625
Phone (312) 869-9654

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1366702953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 N LINCOLN AVE STE 212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252092",
            "telephone_number": "312-869-9654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4770 N LINCOLN AVE STE 212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606252092",
            "telephone_number": "312-869-9654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIPHANT",
        "first_name": "MICHAEL",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-17",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198000983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.