Active NPI
Marcelle Ann Hepburn, LAC
- Acupuncturist
- Lake Villa, IL
National Provider Identifier
1659741791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 198.001267
- Practice address
- 36873 N Deer Trail Dr
Lake Villa, IL 60046-6734 - Phone
- (847) 322-4397
- NPI assigned
- Oct 1, 2015
- Last updated
- Oct 1, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 198.001267 | IL | Primary |
Addresses
Primary practice location
36873 N Deer Trail Dr
Lake Villa, IL 60046-6734
Mailing address
36873 N Deer Trail Dr
Lake Villa, IL 60046-6734
Phone (847) 322-4397
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
| License | State | Type | Specialty |
|---|---|---|---|
| 198.001267 | IL | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443657600000",
"number": "1659741791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36873 N DEER TRAIL DR",
"city": "LAKE VILLA",
"state": "IL",
"postal_code": "600466734",
"telephone_number": "847-322-4397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36873 N DEER TRAIL DR",
"city": "LAKE VILLA",
"state": "IL",
"postal_code": "600466734",
"telephone_number": "847-322-4397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEPBURN",
"first_name": "MARCELLE",
"middle_name": "ANN",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-01",
"last_updated": "2015-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "IL",
"license": "198.001267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Villa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.