Provider Demographics
NPI:1336636257
Name:THE BALANCED KID, INC.
Entity Type:Organization
Organization Name:THE BALANCED KID, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:JURJOVEC
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:630-399-3232
Mailing Address - Street 1:26W333 BAUER RD
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2820
Mailing Address - Country:US
Mailing Address - Phone:630-399-3232
Mailing Address - Fax:
Practice Address - Street 1:825 N CASS AVE STE 109
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-6401
Practice Address - Country:US
Practice Address - Phone:630-399-3232
Practice Address - Fax:331-457-4323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-006463225XP0200X, 261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty