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General NPI Number Information
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NPI Number | 1609235274
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Entity Type | Organization
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Legal Business Name | BALANCE STRESS MANAGEMENT & THERAPY
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Dates
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Enumeration Date | 02/11/2016
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Last Update Date | 02/11/2016
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Provider Practice Location Address
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Address Line | 915 E PARKVIEW DR
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City | SOUTH ELGIN
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State | IL
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Zip | 60177-3262
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Country | US
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Telephone | 815-761-3622
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Fax | 855-260-8266
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Provider Business Mailing Address
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Address Line | 915 E PARKVIEW DR
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City | SOUTH ELGIN
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State | IL
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Zip | 60177-3262
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Country | US
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Telephone | 815-761-3622
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Fax | 855-260-8266
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. AMY MELISSA SCHILLINGER
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Credential | LMFT
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Telephone | 815-761-3622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 166.000876
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License Number State | IL
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