Healthcare Provider Details

I. General information

NPI: 1790069540
Provider Name (Legal Business Name): CHAKA K BATLEY DNP, FPA-APRN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6424 STONE RIDGE DR
QUINCY IL
62305-8824
US

IV. Provider business mailing address

6424 STONE RIDGE DR
QUINCY IL
62305-8824
US

V. Phone/Fax

Practice location:
  • Phone: 217-779-8335
  • Fax: 844-412-9773
Mailing address:
  • Phone: 217-779-8335
  • Fax: 844-412-9773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2020005255
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277000002
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number277000002
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG177278
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: