Basic Information
| Provider Information | |||||||||
| NPI: | 1770844060 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BATISTA | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | MELISSA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 SPALDING DR | ||||||||
| Address2: | SUITE 308 | ||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605406508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305277730 | ||||||||
| FaxNumber: | 6305277732 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 SPALDING DR | ||||||||
| Address2: | SUITE 308 | ||||||||
| City: | NAPERVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605406508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305277730 | ||||||||
| FaxNumber: | 6305277732 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2012 | ||||||||
| LastUpdateDate: | 10/21/2015 | ||||||||
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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 | 363LA2200X | 209.013049 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363L00000X | 2012016691 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.