Provider Demographics
NPI:1285944199
Name:BALANCED BODIES LLC
Entity type:Organization
Organization Name:BALANCED BODIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MEEJUNG
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:630-748-9670
Mailing Address - Street 1:2001 MIDWEST ROAD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:OAKBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1343
Mailing Address - Country:US
Mailing Address - Phone:630-279-0032
Mailing Address - Fax:630-279-1833
Practice Address - Street 1:2001 MIDWEST ROAD
Practice Address - Street 2:SUITE 302
Practice Address - City:OAKBROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1343
Practice Address - Country:US
Practice Address - Phone:630-279-0032
Practice Address - Fax:630-279-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070010605261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy