MEDICARE: CREATING BALANCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1093671646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREATING BALANCE

Provider Business Mailing Address
First Line	:	2059 N LATROBE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-3013
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2059 N LATROBE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-3013
Country	:	US
Telephone Number	:	760-696-5110
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	SHELLIAH WILLIAMS
Credential	:
Telephone Number	:	760-696-5110

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	02/16/2026

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