Healthcare Provider Details

I. General information

NPI: 1568388957
Provider Name (Legal Business Name): BALANCED PSYCHIATRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

544 LAKEVIEW PKWY STE 100
VERNON HILLS IL
60061-1888
US

IV. Provider business mailing address

6697 GILMER RD
LONG GROVE IL
60047-5185
US

V. Phone/Fax

Practice location:
  • Phone: 847-220-4416
  • Fax:
Mailing address:
  • Phone: 847-778-1211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: EVGENIYA MOGILEVSKAYA
Title or Position: OWNER
Credential: APRN, PMHNP-BC
Phone: 847-778-1211