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Organization
A BALANCED LIFE ANTI-AGING CLINIC
Active
Organization
A BALANCED LIFE ANTI-AGING CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YESENIA SERVIN CPMSM (DIRECTOR)
(708) 979-9082
Entity
Organization
Contact information
Practice address
370 E COURTLAND ST, MORTON, IL 61550-9054
(309) 291-0899
Mailing address
370 E COURTLAND ST, MORTON, IL 61550-9054
(309) 291-0899
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/10/2026
Last updated
03/10/2026
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