Basic Information
| Provider Information | |||||||||
| NPI: | 1235119652 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALI | ||||||||
| FirstName: | BATOOL | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1702 W. COUNTY ROAD | ||||||||
| Address2: | |||||||||
| City: | JERSEYVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 62052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184983612 | ||||||||
| FaxNumber: | 6186392008 | ||||||||
| Practice Location | |||||||||
| Address1: | 1702 W. COUNTY ROAD | ||||||||
| Address2: | |||||||||
| City: | JERSEYVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 62052 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184983612 | ||||||||
| FaxNumber: | 6186392008 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 2003017188 | MO | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 206776213 | 05 | MO | MEDICAID |