| Life Balance Medical Center | |
|
5069 Edgemere Ct Roscoe IL 61073-8800 | |
| (815) 623-1013 | |
| (815) 623-1017 |
| Full Name | Life Balance Medical Center |
|---|---|
| Speciality | General Practice |
| Location | 5069 Edgemere Ct, Roscoe, Illinois |
| Authorized Official Name and Position | Alecia Arn (CEO) |
| Authorized Official Contact | 8156231013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Balance Medical Center 5069 Edgemere Ct Roscoe IL 61073-8800 Ph: (815) 623-1013 | Life Balance Medical Center 5069 Edgemere Ct Roscoe IL 61073-8800 Ph: (815) 623-1013 |
| NPI Number | 1790332815 |
|---|---|
| Provider Enumeration Date | 08/22/2019 |
| Last Update Date | 09/13/2022 |
| Medicare PECOS PAC ID | 5991131484 |
|---|---|
| Medicare Enrollment ID | O20200131000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790332815 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Alecia A Arn |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1285632620 PECOS PAC ID: 6901798560 Enrollment ID: I20040327000326 |
| Provider Name | Chandra N Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558878181 PECOS PAC ID: 8022361286 Enrollment ID: I20181105003475 |
| Provider Name | Adeyinka Adebayo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952715294 PECOS PAC ID: 0749612752 Enrollment ID: I20191113001182 |
| Provider Name | Orlandra Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659915163 PECOS PAC ID: 5597198812 Enrollment ID: I20191127000976 |
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