DANIEL ALEXANDER BALUCH (NPI# 1356661680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356661680 |
| Entity Type | Individual |
| Full Name | DANIEL ALEXANDER BALUCH |
| Credential | MD |
| Practice Address |
12701 W 143rd St Ste 200 Homer Glen IL 60491-7715 |
| Practice Telephone | 8776947722 |
| Practice Fax Number | 8155310055 |
| Mailing Telephone | 8776947722 |
| Mailing Fax Number | 8155310055 |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2016-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 2015-00360 | NC | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 125.057652 | IL | Allopathic & Osteopathic Physicians |
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
036.141462 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1356661680 | 05 | |
| SC | NC2392 | 05 |
| Street Address |
12701 W 143RD ST STE 200 |
| City | HOMER GLEN |
| State | IL |
| Zip Code | 60491-7715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821097882 | Roseann M Horan | Family Medicine | 12701 W 143rd St, Ste 230, Homer Glen, IL 60491-7715 | 2005-07-20 |
| 1134477169 | Patricia Clark Md LLC | Surgery | 12701 W 143rd St, Homer Glen, IL 60491-7715 | 2012-08-23 |
| 1891011490 | Matthew Peahl Dc Sc | Rehabilitation Unit | 12701 W 143rd St, Suite 110, Homer Glen, IL 60491-7715 | 2010-04-08 |
| 1942432380 | Jason Welsch | Physician Assistant | 12701 W 143rd St, Suite 200, Homer Glen, IL 60491-7715 | 2009-08-19 |
| 1689841314 | Krzysztof B Siemionow | Orthopaedic Surgery | 12701 W 143rd St, Suite 200, Homer Glen, IL 60491-7715 | 2008-05-12 |
| 1548448681 | O'connor Medical LLC | Internal Medicine | 12701 W 143rd St, Homer Glen, IL 60491-7808 | 2008-01-31 |
| 1568649838 | Homer Glen Pediatrics, Sc | Pediatrics | 12701 W 143rd St, Homer Glen, IL 60491-7808 | 2008-01-29 |
| 1770772006 | Thomas J Vasdekas, M.d. | Surgery | 12701 W 143rd St, Suite 110, Homer Glen, IL 60491-7715 | 2007-10-23 |
| 1659408821 | Jean M. Garbolski Do Sc | Family Medicine | 12701 W 143rd St, Homer Glen, IL 60491-7808 | 2007-02-27 |
| 1578602066 | Homer-lockport Dental Associates, Inc. | Dentist | 12701 W 143rd St, Homer Glen, IL 60491-7808 | 2007-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417490681 | Kellie Calderon | Counselor | 14007 S Bell Rd Ste 183, Homer Glen, IL 60491 | 2016-11-21 |
| 1811249915 | Jasmina Peric | Registered Nurse | 14607 Stonegate Drive, Homer Glen, IL 60491 | 2012-10-12 |
| 1700137783 | Nicole Marie Karn | Physical Therapy Assistant | 14319 Twin Creek Lane, Homer Geln, IL 60491 | 2012-10-01 |
| 1992062061 | South Suburban Hearing, Inc | Hearing Instrument Specialist | 14316 S. Will-cook Rd, Homer Glen, IL 60491 | 2012-04-13 |
| 1336417385 | Crystal Knaack | Pharmacist | 13911 W 167th St, Homer Glen, IL 60491 | 2011-12-06 |
| 1891976429 | Toothworks Inc | Dentist | 12626 W 159th St, Homer Glen, IL 60491 | 2007-11-26 |
| 1972639441 | Barbara A Bayer | Social Worker | 13528 Marissa Ct, Homer Glen, IL 60491 | 2007-02-26 |
| 1093893117 | Daniel L Clark Do Ltd | Family Medicine | 14831 W 159th St, Harris Bank Building, Lockport, IL 60491 | 2006-11-02 |
| 1720006752 | Judith Polkow | Physical Therapist | 14821 S. Founders Crossing, Homer Glen, IL 60491 | 2006-07-17 |
| 1518902188 | Allen Ophthalmic Group | Ophthalmology | 15933 South Bell Road, Homer Glen, IL 60491 | 2006-06-18 |
| Find all providers in zip 60491 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760626717 | Anthony S Rinella M D S C | Orthopaedic Surgery | 12701 W. 143rd Street, Suite 110, Homer Glen, IL 60491-7721 | 2009-04-21 |
| 1689841314 | Krzysztof B Siemionow | Orthopaedic Surgery | 12701 W 143rd St, Suite 200, Homer Glen, IL 60491-7715 | 2008-05-12 |
| 1811961147 | Anthony S Rinella | Orthopaedic Surgery | 12701 W 143rd St, Suite 200, Homer Glen, IL 60491-7715 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093213365 | Joint Replacement Cin of Chicago LLC | Orthopaedic Surgery | 1900 E Golf Rd Ste 950b, Schaumburg, IL 60173-5834 | 2018-01-31 |
| 1063920940 | Spine Cin of Chicago LLC | Orthopaedic Surgery | 1900 E Golf Rd Ste 950a, Schaumburg, IL 60173-5034 | 2018-01-13 |
| 1851819221 | Bernard Rerri | Orthopaedic Surgery | 938 M L King Dr, Centralia, IL 62801-3058 | 2017-09-06 |
| 1932572872 | Egyptian Spine Clinic | Orthopaedic Surgery | 1007 M L King Dr, Centralia, IL 62801-3001 | 2015-10-31 |
| 1073873675 | Joseph Patrick Brindise | Orthopaedic Surgery | 500 W Golf Rd Ste 101, Schaumburg, IL 60195-3503 | 2012-05-17 |
| 1861785354 | Prairie Spine & Pain Institute of Southern Illinois, LLC | Orthopaedic Surgery | 1306 N Russell St, Marion, IL 62959-4570 | 2011-05-17 |
| 1265602965 | Brandy Arnett | Orthopaedic Surgery | 800 Biesterfield Rd Ste 565, Eberle Prof Bldg, Elk Grove, IL 60007-3362 | 2008-03-10 |
| 1609940972 | Giri T Gireesan | Orthopaedic Surgery | 676 North St Clair St, #1777, Chicago, IL 60611 | 2006-11-20 |
| 1700981107 | Carl N Graf IIi | Orthopaedic Surgery | 1990 E Algonquin Road, Suite 160, Schaumburg, IL 60173 | 2006-09-13 |
| 1528178654 | Stephen J Pineda | Orthopaedic Surgery | 800 N. 1st St., Springfield, IL 62702 | 2006-08-30 |
| Find all providers with the same taxonomy | ||||
| City | HOMER GLEN |
| Zip Code | 60491 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.