{
  "npi": "1730299652",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MD",
    "authorized_official_first_name": "KWAN BO",
    "authorized_official_last_name": "JIN",
    "authorized_official_name_prefix": "Dr.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "8474964216",
    "authorized_official_title_or_position": "President",
    "enumeration_date": "2006-08-30",
    "last_updated": "2020-08-22",
    "organization_name": "BALANCED LIFE SC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 946",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "STREAMWOOD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "630-497-1379",
      "postal_code": "601073305",
      "state": "IL",
      "telephone_number": "630-497-1730"
    },
    {
      "address_1": "1650 MOON LAKE BLVD",
      "address_2": "ATTN: DR JIN",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "HOFFMAN ESTATES",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "847-358-7516",
      "postal_code": "601941010",
      "state": "IL",
      "telephone_number": "947-496-4216"
    }
  ],
  "taxonomies": [
    {
      "code": "2084P0800X",
      "desc": "Psychiatry & Neurology, Psychiatry",
      "license": "036069415",
      "primary": true,
      "state": "IL",
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": true,
      "status": "EXCLUDED",
      "matches": [
        {
          "name": "BALANCED LIFE, S C",
          "npi": "1730299652",
          "specialty": "CLINIC",
          "city": "PALATINE",
          "state": "IL",
          "excl_type": "1128b8",
          "excl_date": "2011-12-20",
          "statute_desc": "Sec. 1128(b)(8) — Entities Controlled by a Sanctioned Individual"
        }
      ],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Board-Certified Psychiatrist (Mental Health & Behavioral Medicine Physician)",
    "certifying_board": "American Board of Psychiatry and Neurology (ABPN)",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "26",
        "medicare_type": "Physician/Psychiatry"
      },
      {
        "medicare_code": "86",
        "medicare_type": "Physician/Neuropsychiatry"
      }
    ]
  }
}