NPIMap

Organization Active NPI

Acubalance Wellness Center, LLC

  • Acupuncturist
  • Chicago, IL
National Provider Identifier
1366778730
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
198-000837 Issued in IL
Legal business name
ACUBALANCE WELLNESS CENTER, LLC
Practice address
6015 N Nina Ave
Chicago, IL 60631-2411
Phone
(773) 775-4257
Fax
(773) 775-4845
NPI assigned
Oct 20, 2009
Last updated
Oct 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Authorized official

Name
Ms. Juliann M Domagalski, L.AC.
Title
Co-Owner
Phone
(773) 775-4257

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 198-000837 IL Primary
Reflexologist 173C00000X NA IL

Addresses

Primary practice location

6015 N Nina Ave
Chicago, IL 60631-2411

Mailing address

6015 N Nina Ave
Chicago, IL 60631-2411
Phone (773) 775-4257

National Provider Directory

National Provider Directory
Tax ID family
Acubalance Wellness Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6015 N Nina Ave
Chicago, IL 60631
Phone (773) 775-4257

NPI Registry JSON

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1366778730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 N NINA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312411",
            "telephone_number": "773-775-4257",
            "fax_number": "773-775-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 N NINA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312411",
            "telephone_number": "773-775-4257",
            "fax_number": "773-775-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACUBALANCE WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "DOMAGALSKI",
        "authorized_official_first_name": "JULIANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "773-775-4257",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": "198-000837",
            "primary": true
        },
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "IL",
            "license": "NA",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.