Healthcare Provider Details

I. General information

NPI: 1770565947
Provider Name (Legal Business Name): ROBERT ANDREW BATTISTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 SALT CREEK LN SUITE 101
HINSDALE IL
60521-2990
US

IV. Provider business mailing address

11 SALT CREEK LN SUITE 101
HINSDALE IL
60521-2990
US

V. Phone/Fax

Practice location:
  • Phone: 630-789-3110
  • Fax: 630-789-3137
Mailing address:
  • Phone: 630-789-3110
  • Fax: 630-789-3137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number036085232
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: