Basic Information
Provider Information
NPI: 1295455285
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BALMES
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 201 N GARLAND CT UNIT 2107
Address2:  
City: CHICAGO
State: IL
PostalCode: 606013720
CountryCode: US
TelephoneNumber: 2482276797
FaxNumber:  
Practice Location
Address1: 251 E HURON ST
Address2:  
City: CHICAGO
State: IL
PostalCode: 606113055
CountryCode: US
TelephoneNumber: 3129262000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/30/2022
LastUpdateDate: 08/30/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X041453582ILY Nursing Service ProvidersRegistered Nurse 

No ID Information.


Home