Provider Demographics
NPI:1134508864
Name:BALDETTI, JESSICA (DO)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:BALDETTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7435 W TALCOTT AVE
Mailing Address - Street 2:RESURRECTION OB/GYN RESIDENCY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:226 S WOODS MILL RD STE 68W
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3665
Practice Address - Country:US
Practice Address - Phone:314-205-6788
Practice Address - Fax:314-590-5954
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL125066850207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology