Healthcare Provider Details

I. General information

NPI: 1073450771
Provider Name (Legal Business Name): BALANCED INSIDE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 MAIN ST STE 8
DOWNERS GROVE IL
60516-3455
US

IV. Provider business mailing address

2211 EVERGREEN LN
WOODRIDGE IL
60517-3510
US

V. Phone/Fax

Practice location:
  • Phone: 708-292-8337
  • Fax:
Mailing address:
  • Phone: 630-805-1537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIANA KESTERSON
Title or Position: THERAPIST
Credential: LCSW
Phone: 630-805-1537