# A BALANCED LIFE ANTI-AGING CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780531723
- **Authorized official:** YESENIA SERVIN CPMSM (DIRECTOR)
- **Authorized official phone:** (708) 979-9082

## Contact information

- **Practice address:** 370 E COURTLAND ST, MORTON, IL 61550-9054
- **Practice address phone:** (309) 291-0899
- **Mailing address:** 370 E COURTLAND ST, MORTON, IL 61550-9054
- **Mailing address phone:** (309) 291-0899

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/10/2026
- **Last updated:** 03/10/2026