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General NPI Number Information
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NPI Number | 1457576621
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Entity Type | Individual
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Provider Name | PAMELA A BALLARD DC
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Gender | Female
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Dates
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Enumeration Date | 04/14/2007
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Last Update Date | 08/10/2022
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Provider Practice Location Address
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Address Line | 7N315 SYCAMORE AVE
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City | MEDINAH
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State | IL
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Zip | 60157-9799
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Country | US
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Telephone | 630-307-7463
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Fax | 630-529-0087
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Provider Business Mailing Address
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Address Line | PO BOX 460
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City | MEDINAH
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State | IL
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Zip | 60157-0460
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Country | US
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Telephone | 630-529-0077
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Fax | 630-529-0087
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 038-006728
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License Number State | IL
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