SearchIllinois225700000X

Scott Kingphavong, LMT

NPI 1710333638 · on the registry since 2016 · sole proprietor

Practice

Address
5936 Essex Rd
Oak Forest, IL 60452
Phone
(779) 774-5493

Additional practice sites

  • 7124 Windsor Lake Pkwy, Loves Park, IL

Registry record

Primary taxonomy
225700000X
225700000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-10-01

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois