Organization Active NPI

Back in Balance Chiropractic & Acupuncture Center, LTD.

  • Chiropractor
  • Western Springs, IL
National Provider Identifier
1104041706
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38009671 Issued in IL
Legal business name
BACK IN BALANCE CHIROPRACTIC & ACUPUNCTURE CENTER, LTD.
Practice address
518 Hillgrove Ave Ste 275
Western Springs, IL 60558-1460
Phone
(708) 588-8270
Fax
(708) 588-8271
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michelle McPolin Boyd, D.C.NPI 1790806461
Title
President
Phone
(708) 588-8270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38009671 IL Primary

Addresses

Primary practice location

518 Hillgrove Ave Ste 275
Western Springs, IL 60558-1460

Mailing address

518 Hillgrove Ave Ste 275
Western Springs, IL 60558-1460
Phone (708) 588-8270

Other identifiers 1

IdentifierTypeStateIssuer
01632424OtherILBCBS OF IL ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050620000037 IL Part B Supplier - Clinic/Group Practice 9739123845 Receives reassigned benefits from 3 practitioners
Practice locations: Western Springs, IL

National Provider Directory

National Provider Directory

Locations

18 W 1st St
Ste 2
Hinsdale, IL 60521
Phone (630) 455-5885

440 Sherwood Rd
La Grange Pk, IL 60526
Phone (708) 579-1003

355 N La Grange Rd
La Grange Pk, IL 60526
Phone (708) 588-8270

518 Hillgrove Ave
Ste 275
Western Springs, IL 60558
Phone (708) 588-8270

16W501 Nielson Ln
Willowbrook, IL 60527
Phone (630) 455-5885

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440547200000",
    "number": "1104041706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 HILLGROVE AVE STE 275",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581460",
            "telephone_number": "708-588-8270",
            "fax_number": "708-588-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 HILLGROVE AVE STE 275",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581460",
            "telephone_number": "708-588-8270",
            "fax_number": "708-588-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN BALANCE CHIROPRACTIC & ACUPUNCTURE CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2015-08-26",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "MCPOLIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-588-8270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38009671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL ID #",
            "identifier": "01632424",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Western Springs, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.