Kids in Balance LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

KIDS IN BALANCE LLC

Practice address

2312 W Medill Ave Unit 1
Chicago, IL 60647-3234

Phone

(773) 405-6020

Fax

(877) 217-2357

NPI assigned

Sep 12, 2018

Organization subpart

No

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

Authorized official

Name

Evette Coll, PT

Title

Manager

Phone

(773) 405-6020

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536710400000",
    "number": "1104309426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 W MEDILL AVE UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473234",
            "telephone_number": "773-405-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 W MEDILL AVE UNIT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473234",
            "telephone_number": "773-405-6020",
            "fax_number": "877-217-2357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS IN BALANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-12",
        "last_updated": "2018-09-12",
        "status": "A",
        "authorized_official_last_name": "COLL",
        "authorized_official_first_name": "EVETTE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-405-6020",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.