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LIFE BALANCE MEDICAL CENTER NPI 1790332815


NPI Information

NPI: 1790332815
Provider Name: LIFE BALANCE MEDICAL CENTER
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
5069 EDGEMERE CT
ROSCOE, IL
ZIP 61073
Phone: (815) 623-1013
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LIFE BALANCE MEDICAL CENTER is a general practice in Roscoe, IL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee LIFE BALANCE MEDICAL CENTER NPI is 1790332815. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5069 EDGEMERE CT
ROSCOE, IL
ZIP 61073-800
Phone: (815) 623-1013
Fax: (815) 623-1017

The provider's authorized official is Alecia Arn .
The authorized official title is Ceo and has the following contact phone number (815) 623-1013.

The enumeration date for this NPI number is 8/22/2019 and was last updated on 9/13/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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