Provider Demographics
NPI:1982488045
Name:BALANCED FLOW LIFE LLC
Entity Type:Organization
Organization Name:BALANCED FLOW LIFE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALINOWSKA HERTSBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-880-9697
Mailing Address - Street 1:2325 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-5369
Mailing Address - Country:US
Mailing Address - Phone:312-880-9697
Mailing Address - Fax:
Practice Address - Street 1:2325 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-5369
Practice Address - Country:US
Practice Address - Phone:312-880-9697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty