Healthcare Provider Details

I. General information

NPI: 1316388796
Provider Name (Legal Business Name): JOSEFINA BATISTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2013
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 W 95TH ST STE 400
EVERGREEN PARK IL
60805-2755
US

IV. Provider business mailing address

465 N PARK DR APT 3904
CHICAGO IL
60611-0014
US

V. Phone/Fax

Practice location:
  • Phone: 708-424-7600
  • Fax: 708-424-7605
Mailing address:
  • Phone: 352-804-2692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036144838
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: