| Dr Bill Bautista Lcsw Llc | |
|
2205 Point Blvd Ste 210 Elgin IL 60123-7840 | |
| (847) 946-2958 | |
| Not Available |
| Full Name | Dr Bill Bautista Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2205 Point Blvd Ste 210, Elgin, Illinois |
| Authorized Official Name and Position | William Bautista (OWNER / PSYCHOTHERAPIST) |
| Authorized Official Contact | 8479462958 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Bill Bautista Lcsw Llc 2205 Point Blvd Ste 210 Elgin IL 60123-7840 Ph: (847) 946-2958 | Dr Bill Bautista Lcsw Llc 2205 Point Blvd Ste 210 Elgin IL 60123-7840 Ph: (847) 946-2958 |
| NPI Number | 1699483156 |
|---|---|
| Provider Enumeration Date | 11/14/2022 |
| Last Update Date | 11/14/2022 |
| Certification Date | 11/13/2022 |
| Medicare PECOS PAC ID | 2567831746 |
|---|---|
| Medicare Enrollment ID | O20221209001398 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699483156 | NPI | - | NPPES |
| 149015794 | Other | IL | LCSW |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | William Bautista |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023351376 PECOS PAC ID: 0345464665 Enrollment ID: I20140606000873 |
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