Balanced Life SC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BALANCED LIFE SC

Practice address

1650 Moon Lake Blvd
Attn: Dr Jin
Hoffman Estates, IL 60194-1010

Phone

(947) 496-4216

Fax

(847) 358-7516

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kwan Bo Jin, MD

Title

President

Phone

(847) 496-4216

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Practitioners 2

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

• Kwan Bo Jin, M.D.

  • Psychiatry Physician
  • Hoffman Estates, IL
  • NPI 1376578039

  Psychiatry

  NPD (past)
• Mohammad Javed, M.D

  • Psychiatry Physician
  • Merrillville, IN
  • NPI 1093738296

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730299652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 946",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601073305",
            "telephone_number": "630-497-1730",
            "fax_number": "630-497-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 MOON LAKE BLVD",
            "address_2": "ATTN: DR JIN",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601941010",
            "telephone_number": "947-496-4216",
            "fax_number": "847-358-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED LIFE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JIN",
        "authorized_official_first_name": "KWAN BO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-496-4216",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER MEDICARE NUMBER",
            "identifier": "K14712",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER MEDICARE NUMBER",
            "identifier": "K14710",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER MEDICARE NUMBER",
            "identifier": "K14711",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda C Baker, LCPC
• Matangi Priyasri Bala, MD
• Balance Chiropractic and Wellness LLC
• Balance Health Fitness Physical Therapy and Coaching LLC
• Balanced Care Chiropractic LLC
• Irineo Ocsio Banas Jr., SA-C
• Kamlesh Banker, LCSW
• Lauren Bantner
• Anishmah Banu
• Donna M Barker, MS, ANP-C, ONC, RN-C

• All providers in Hoffman Estates, IL
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.