Provider Demographics
NPI:1437554086
Name:CREST HILL CLINIC LTD
Entity Type:Organization
Organization Name:CREST HILL CLINIC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BALSIER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-439-2121
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:
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0385083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1376548388OtherNPI