| Maria Riza Bautista Md Sc | |
|
326 W 64th St Suite # 302 Chicago IL 60621-3114 | |
| (773) 487-5224 | |
| Not Available |
| Full Name | Maria Riza Bautista Md Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 326 W 64th St, Chicago, Illinois |
| Authorized Official Name and Position | Maria Riza Bautista (PHYSICIAN) |
| Authorized Official Contact | 7734875224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maria Riza Bautista Md Sc 326 W 64th St Suite # 302 Chicago IL 60621-3114 Ph: (773) 487-5224 | Maria Riza Bautista Md Sc 326 W 64th St Suite # 302 Chicago IL 60621-3114 Ph: (773) 487-5224 |
| NPI Number | 1013190727 |
|---|---|
| Provider Enumeration Date | 12/17/2007 |
| Last Update Date | 03/27/2008 |
| Medicare PECOS PAC ID | 3274615901 |
|---|---|
| Medicare Enrollment ID | O20080201000536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013190727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Illinois) | Primary |
| Provider Name | Maria Riza D Bautista |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154400513 PECOS PAC ID: 8426057787 Enrollment ID: I20061214000079 |
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