Balabanov, Antoaneta Y

Balabanov, Antoaneta Y is an individual health care provider with primary practice located at 1725 W Harrison St Suite 1106, Chicago IL 60612-3841. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Balabanov, Antoaneta Y can be contacted via phone (312) 942-5936.

Contact Information

Primary practice address
1725 W Harrison St Suite 1106 Chicago IL 60612-3841
Phone: (312) 942-5936
Fax: (312) 942-2380
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 036103242 Illinois
Allopathic & Osteopathic Physicians / Clinical Neurophysiology 2084N0600X 036103242 Illinois

Profile Details

NPI number 1770578304
LBN Legal business name Balabanov, Antoaneta Y
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Sep 21st, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770578304 NPPES
Illinois MEDICAID 036103242
Illinois Other BB7272432
Illinois Other 336064985

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