Provider Demographics
NPI:1548972938
Name:ACULIFESTYLE WELLNESS LLC
Entity type:Organization
Organization Name:ACULIFESTYLE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DACCHM, LAC
Authorized Official - Phone:224-398-3607
Mailing Address - Street 1:1555 N ASTOR ST APT 5SE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-6712
Mailing Address - Country:US
Mailing Address - Phone:312-371-9540
Mailing Address - Fax:
Practice Address - Street 1:1555 N ASTOR ST APT 5SE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-6712
Practice Address - Country:US
Practice Address - Phone:224-398-3607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty