Provider Demographics
NPI:1851506653
Name:BALANCING POINT CENTER FOR WELLNESS
Entity Type:Organization
Organization Name:BALANCING POINT CENTER FOR WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:773-271-8284
Mailing Address - Street 1:4753 N BROADWAY ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5266
Mailing Address - Country:US
Mailing Address - Phone:773-271-8284
Mailing Address - Fax:
Practice Address - Street 1:4753 N BROADWAY ST
Practice Address - Street 2:SUITE 101
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5266
Practice Address - Country:US
Practice Address - Phone:773-271-8284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008534111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL971770OtherMEDICARE PTAN
IL01632897OtherBCBS
IL01632897OtherBCBS
IL971770OtherMEDICARE PTAN