Organization Active NPI

Rooted Acupuncture Medicine PLLC

  • Acupuncturist
  • Chicago, IL
National Provider Identifier
1780425157
Registry record updated Jun 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
ROOTED ACUPUNCTURE MEDICINE PLLC
Practice address
2915 N Lincoln Ave
Chicago, IL 60657-4108
Phone
(312) 298-9577
NPI assigned
Jun 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2024

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

Authorized official

Name
Justina PhamNPI 1144840836
Title
Owner
Phone
(773) 969-0452

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X Primary

Addresses

Primary practice location

2915 N Lincoln Ave
Chicago, IL 60657-4108

Mailing address

2915 N Lincoln Ave
Chicago, IL 60657-4108
Phone (773) 969-0452

Other names 1

  • Rooted Acupuncture Doing business as

National Provider Directory

National Provider Directory

Locations

2915 N Lincoln Ave
Chicago, IL 60657
Phone (312) 298-9577

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1717200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717200000000",
    "number": "1780425157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574108",
            "telephone_number": "773-969-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574108",
            "telephone_number": "312-298-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTED ACUPUNCTURE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-01",
        "last_updated": "2024-06-01",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "JUSTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-969-0452"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rooted Acupuncture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 1, 2024; 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.