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General NPI Number Information
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NPI Number | 1134408917
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Entity Type | Organization
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Legal Business Name | BALANCED CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 4711 GOLF RD SUITE 413
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City | SKOKIE
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State | IL
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Zip | 60076-1224
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Country | US
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Telephone | 847-626-9450
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Fax |
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Provider Business Mailing Address
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Address Line | 79 SALEM LN
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City | EVANSTON
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State | IL
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Zip | 60203-1217
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Country | US
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Telephone | 847-626-9450
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. HARRY KAHN
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Credential | D.C.
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Telephone | 847-983-4660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038009683
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License Number State | IL
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