Balanced Flow Medical Llc | |
2325 W North Ave, Chicago, IL 60647-5369 | |
(312) 880-9697 | |
Not Available |
Full Name | Balanced Flow Medical Llc |
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Type | Facility |
Speciality | General Practice |
Location | 2325 W North Ave, Chicago, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336656701 | NPI | - | NPPES |
1225442502 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
208D00000X | General Practice | 038012628 (Illinois) | Primary |
Provider Name | Danish Haque |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1336193093 PECOS PAC ID: 0446235410 Enrollment ID: I20040623000385 |
Provider Name | Nolan Lee |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1679988018 PECOS PAC ID: 4688925332 Enrollment ID: I20180919003898 |
Provider Name | Dominika Malinowska Hertsberg |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1225442502 PECOS PAC ID: 3779834429 Enrollment ID: I20180919004051 |
Provider Name | Aya Dajani |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033615158 PECOS PAC ID: 5991056640 Enrollment ID: I20180919004113 |
Provider Name | Michael J Gontarek |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1467917856 PECOS PAC ID: 6507198157 Enrollment ID: I20191031000018 |
Provider Name | Lauralea Thomas |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104393115 PECOS PAC ID: 3072933282 Enrollment ID: I20201008002347 |
Provider Name | Amanda Kostic |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629648225 PECOS PAC ID: 6507254182 Enrollment ID: I20211101002606 |
Mailing Address | Practice Location Address |
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Balanced Flow Medical Llc 2325 W North Ave, Chicago, IL 60647-5369 Ph: (312) 880-9697 | Balanced Flow Medical Llc 2325 W North Ave, Chicago, IL 60647-5369 Ph: (312) 880-9697 |