Organization Active NPI

Balance Mental Health PLLC

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1407608979
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BALANCE MENTAL HEALTH PLLC
Practice address
123 S Green St Apt 506B
Chicago, IL 60607-3663
Phone
(312) 248-3050
NPI assigned
Apr 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Eric Tiede, MDNPI 1609361799
Title
MD/Owner
Phone
(312) 248-3050

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
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

123 S Green St Apt 506B
Chicago, IL 60607-3663

Mailing address

123 S Green St Apt 506B
Chicago, IL 60607-3663

Other practice location 1

405 N Wabash Ave Unit 3804
Chicago, IL 60611-5608
Phone (312) 248-3050

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1712275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1407608979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 S GREEN ST APT 506B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 S GREEN ST APT 506B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073663",
            "telephone_number": "312-248-3050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 N Wabash Ave Unit 3804",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606115608",
            "country_code": "US",
            "telephone_number": "312-248-3050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BALANCE MENTAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "TIEDE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "312-248-3050",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Aug 28, 2024; 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.