Vital Balance Psychiatry PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

VITAL BALANCE PSYCHIATRY PLLC

Practice address

1100 Central Ave Unit F-3
Wilmette, IL 60091-2666

Phone

(312) 600-8533

NPI assigned

Jul 20, 2023

Organization subpart

No

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

Authorized official

Name

Gabriel Heiber, MD

Title

MD

Phone

(312) 600-8533

Specialties & licenses 1

Addresses

Other names 1

• Vital Balance Psychiatry PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Gabriel Jose Heiber Bendayan, M.D

  • Psychosomatic Medicine Physician
  • Wilmette, IL
  • NPI 1679991160

  Psychiatry

  Medicare reassignment NPD

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1679253140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE UNIT F-3",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE UNIT F-3",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912666",
            "telephone_number": "312-600-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL BALANCE PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A",
        "authorized_official_last_name": "HEIBER",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "312-600-8533",
        "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": [
        {
            "organization_name": "Vital Balance Psychiatry PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vital Balance Psychiatry PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Village Dermatology, SC
• Village of Wilmette
• Village of Wilmette
• Kannan Vinaitheerthan, LCSW
• Viridian Medical Group, PLLC
• Emily Vo
• Patricia Viviana Voloschin-Weiner, LCPC
• Amy Claire Wagner, PH.D., L.M.F.T.
• Carolyn Wagner, MA, LPC
• Marisa Wakely

• Psychiatry Physician in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.