Balanced Body Integrated Wellness S.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.008066 Issued in IL

Legal business name

BALANCED BODY INTEGRATED WELLNESS S.C.

Practice address

2569 W Fullerton Avenue
Chicago, IL 60647-3147

Phone

(773) 252-9740

Fax

(773) 252-9746

NPI assigned

Apr 12, 2012

Organization subpart

No

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

Authorized official

Name

Jee Hoon Kim, D.C.

Title

Owner / Chiropractor

Phone

(773) 252-9740

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1699032813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2569 W FULLERTON AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473147",
            "telephone_number": "773-252-9740",
            "fax_number": "773-252-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2569 W FULLERTON AVENUE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473147",
            "telephone_number": "773-252-9740",
            "fax_number": "773-252-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED BODY INTEGRATED WELLNESS S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JEE",
        "authorized_official_middle_name": "HOON",
        "authorized_official_title_or_position": "OWNER / CHIROPRACTOR",
        "authorized_official_telephone_number": "773-252-9740",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.008066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Chicago, IL
• Providers in Chicago, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.