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NPI Code Detail

MEDICARE: BALANCED BODY INTEGRATED WELLNESS S.C.

MEDICARE: BALANCED BODY INTEGRATED WELLNESS S.C.
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
1111N00000XChiropractor038.008066IL

General Provider Information

NPI Number : 1699032813
Entity Type Code : Organization
Provider Name (Legal Business Name) : BALANCED BODY INTEGRATED WELLNESS S.C.
Provider Business Mailing Address
First Line : 2569 W FULLERTON AVENUE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-3147
Country : US
Telephone Number : 773-252-9740
Fax Number : 773-252-9746
Provider Business Practice Location Address
First Line : 2569 W FULLERTON AVENUE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-3147
Country : US
Telephone Number : 773-252-9740
Fax Number : 773-252-9746
Authorized Official
Title or Position : OWNER / CHIROPRACTOR
Name : JEE HOON KIM
Credential : D.C.
Telephone Number : 773-252-9740
Provider Enumeration Date : 04/12/2012
Last Update Date : 04/12/2012

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Directions to “BALANCED BODY INTEGRATED WELLNESS S.C. ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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