National Provider Identifier Database

FUNCTIONALLY BALANCED BODYWORK CLINICS LLC
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).


Contact Information

FUNCTIONALLY BALANCED BODYWORK CLINICS, LLC
3850 W 95TH ST FL 1
EVERGREEN PARK, IL60805-2006
Phone: 708-529-7111
Fax: 708-843-5811
Website:
Specialty Taxonomy Code
* Clinic/Center 261Q00000X
Acupuncturist 171100000X
Chiropractor 111N00000X
Massage Therapist 225700000X
Physical Therapy Assistant 225200000X

* Indicates primary specialty

NPI Profile & details for FUNCTIONALLY BALANCED BODYWORK CLINICS, LLC

NPI Number 1497210850
Legal business name
LBN
FUNCTIONALLY BALANCED BODYWORK CLINICS, LLC
Authorized official THERESA STARK - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 02/08/2019
Last updated 02/08/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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