Organization
BALANCE & WELLBEING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOVEL BROQUEZA APRN (ADMINISTRATOR)
(630) 344-9617
Entity
Organization
Contact information
Practice address
1051 PERIMETER DR STE 1100, SCHAUMBURG, IL 60173-5079
(630) 344-9617
(847) 648-4122
Mailing address
PO BOX 699, CAMAS, WA 98607-0699
(360) 903-1829
(360) 991-0337
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10029352
OREGON BOARD OF NURSING
OR
01
—
AP61586857
WASHINGTON BOARD OF NURSING
WA
Enumeration date
08/05/2019
Last updated
10/01/2024
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