Provider Demographics
NPI:1780570135
Name:SHEFALEV VR LLC
Entity type:Organization
Organization Name:SHEFALEV VR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:LIVYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALLIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-517-1549
Mailing Address - Street 1:2632 W MORSE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-4517
Mailing Address - Country:US
Mailing Address - Phone:718-517-1549
Mailing Address - Fax:
Practice Address - Street 1:2632 W MORSE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-4517
Practice Address - Country:US
Practice Address - Phone:718-517-1549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty