MEDICARE: MRS. MAJA BALABAN LUKE CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	209-004809	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316955057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAJA BALABAN LUKE CNM

Provider Business Mailing Address
First Line	:	29373 NETWORK PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-1293
Country	:	US
Telephone Number	:	847-390-5900
Fax Number	:

Provider Business Practice Location Address
First Line	:	3134 NORTH CLARK STREET
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-6704
Country	:	US
Telephone Number	:	773-296-7032
Fax Number	:	773-296-3096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	04/07/2025

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