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General NPI Number Information
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NPI Number | 1215811302
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Entity Type | Organization
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Legal Business Name | BALANCED ENERGY ACUPUNCTURE LLC
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Dates
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Enumeration Date | 08/02/2025
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Last Update Date | 08/02/2025
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Provider Practice Location Address
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Address Line | 3832 N BROADWAY ST
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City | CHICAGO
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State | IL
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Zip | 60613-3218
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Country | US
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Telephone | 847-363-6325
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Fax |
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Provider Business Mailing Address
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Address Line | 3832 N BROADWAY ST
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City | CHICAGO
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State | IL
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Zip | 60613-3218
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MRS. PATRYCJA MARIA DANIEL
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Credential | L.AC.
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Telephone | 847-363-6325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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