Provider Demographics
NPI:1376548388
Name:BALSIER, PATRICK (DC)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:BALSIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-1467
Mailing Address - Country:US
Mailing Address - Phone:815-439-2121
Mailing Address - Fax:815-439-2153
Practice Address - Street 1:2430 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-1467
Practice Address - Country:US
Practice Address - Phone:815-439-2121
Practice Address - Fax:815-439-2153
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL385083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0998202537OtherBLUE CROSS
ILT38380Medicare UPIN
IL60900Medicare ID - Type Unspecified