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General NPI Number Information
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NPI Number | 1699483156
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Entity Type | Organization
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Legal Business Name | DR BILL BAUTISTA LCSW LLC
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 2205 POINT BLVD STE 210
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City | ELGIN
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State | IL
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Zip | 60123-7840
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Country | US
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Telephone | 847-946-2958
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Fax |
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Provider Business Mailing Address
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Address Line | 2205 POINT BLVD STE 210
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City | ELGIN
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State | IL
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Zip | 60123-7840
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Country | US
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Telephone | 847-946-2958
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Fax |
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Authorized Official
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Title or Position | OWNER / PSYCHOTHERAPIST
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Name | DR. WILLIAM BAUTISTA
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Credential | DSW, LCSW
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Telephone | 847-946-2958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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