Provider Demographics
NPI:1548802598
Name:BALABAN, YELENA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:BALABAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 GARLANDS LN STE 180
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-6029
Mailing Address - Country:US
Mailing Address - Phone:847-620-7185
Mailing Address - Fax:847-852-3771
Practice Address - Street 1:6000 GARLANDS LN STE 180
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-6029
Practice Address - Country:US
Practice Address - Phone:847-620-7185
Practice Address - Fax:847-852-3771
Is Sole Proprietor?:No
Enumeration Date:2019-10-11
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209020209363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner