Provider Demographics
NPI:1942640479
Name:BODIES IN BALANCE WHOLE HEALTH, LLC
Entity Type:Organization
Organization Name:BODIES IN BALANCE WHOLE HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:HAL
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-562-0890
Mailing Address - Street 1:3100 DUNDEE RD STE 504
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2449
Mailing Address - Country:US
Mailing Address - Phone:847-562-0890
Mailing Address - Fax:773-634-8282
Practice Address - Street 1:3100 DUNDEE RD STE 504
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2449
Practice Address - Country:US
Practice Address - Phone:847-562-0890
Practice Address - Fax:773-634-8282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038007974111NI0900X
IL038010326111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0900XChiropractic ProvidersChiropractorInternistGroup - Single Specialty