Provider Demographics
NPI:1649968058
Name:RIGHT BALANCED LIVING
Entity type:Organization
Organization Name:RIGHT BALANCED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOB
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:630-670-6107
Mailing Address - Street 1:103 FOUNDERS POINTE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1440
Mailing Address - Country:US
Mailing Address - Phone:630-670-6107
Mailing Address - Fax:
Practice Address - Street 1:1 TIFFANY PT
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2936
Practice Address - Country:US
Practice Address - Phone:630-828-6821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty