Organization · NPI-2

Affiliated Chicago Physicians

Acupuncturist · Chicago, IL

NPI number1629015524

StatusActive

Last updated in NPPESSep 11, 2025

Details

NPI: 1629015524
Entity type: Organization (NPI-2)
Legal business name: Affiliated Chicago Physicians
Organization subpart: No
Enumeration date: May 31, 2006
Last updated: Sep 11, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
171100000X	Acupuncturist	–	–	Yes
207R00000X	Internal Medicine	–	–
207P00000X	Emergency Medicine	–	–
207V00000X	Obstetrics & Gynecology	–	–
213E00000X	Podiatrist	–	–
207Q00000X	Family Medicine	–	–
111N00000X	Chiropractor	–	–

Other names

Affiliated Chicago Physicians (Former Legal Business Name)

Practice location

4849 W Fullerton Ave
Chicago, IL 60639-2503

Phone 773-237-0755 · Fax 773-237-0785

Mailing address

4849 W Fullerton Ave
Chicago, IL 60639-2503

Phone 773-237-0755 · Fax 773-237-0785

Authorized official

Naser Rustom
Owner
7733959400

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.