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General NPI Number Information
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NPI Number | 1215887286
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Entity Type | Individual
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Provider Name | LARA ELAINE BALAY CGC
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Gender | Female
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Dates
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Enumeration Date | 01/30/2026
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 1818 WEST TAYLOR STREET
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City | CHICAGO
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State | IL
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Zip | 60612
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Country | US
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Telephone | 312-355-3248
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Fax | 312-413-5290
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Provider Business Mailing Address
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Address Line | 840 SOUTH WOOD STREET, 820E CSB (MC 713)
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City | CHICAGO
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State | IL
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Zip | 60612
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Country | US
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Telephone | 312-355-3248
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Fax | 312-413-5290
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | 246.000198
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License Number State | IL
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