Healthcare Provider Details

I. General information

NPI: 1215853858
Provider Name (Legal Business Name): EIDEH BATARSEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EIDEH BATARSEH ROSE MSW, LSW

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37W755 IL ROUTE 38
ST CHARLES IL
60175-7507
US

IV. Provider business mailing address

334 N MAIN ST
SYCAMORE IL
60178-1433
US

V. Phone/Fax

Practice location:
  • Phone: 312-550-0702
  • Fax:
Mailing address:
  • Phone: 312-550-0702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.119129
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: