Healthcare Provider Details

I. General information

NPI: 1598321804
Provider Name (Legal Business Name): MARIA REMEDIOS MARCELO BILLOTE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 09/14/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601COMPASS ROAD #140
GLENVIEW IL
60026
US

IV. Provider business mailing address

214 CENTERVIEW DR STE 250
BRENTWOOD TN
37027-3248
US

V. Phone/Fax

Practice location:
  • Phone: 847-503-0007
  • Fax: 312-253-7244
Mailing address:
  • Phone: 630-332-8235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209.019298
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209019298
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: