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General NPI Number Information
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NPI Number | 1649968058
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Entity Type | Organization
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Legal Business Name | RIGHT BALANCED LIVING
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Dates
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Enumeration Date | 04/25/2023
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Last Update Date | 04/25/2023
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Provider Practice Location Address
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Address Line | 1 TIFFANY PT
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2936
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Country | US
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Telephone | 630-828-6821
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Fax |
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Provider Business Mailing Address
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Address Line | 103 FOUNDERS POINTE S
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1440
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Country | US
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Telephone | 630-670-6107
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | BETSY JACOB
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Credential | APN
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Telephone | 630-670-6107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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