Provider Demographics
NPI:1598321804
Name:BILLOTE, MARIA REMEDIOS MARCELO (NP)
Entity Type:Individual
Prefix:
First Name:MARIA REMEDIOS
Middle Name:MARCELO
Last Name:BILLOTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 CENTERVIEW DR STE 250
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3248
Mailing Address - Country:US
Mailing Address - Phone:630-332-8235
Mailing Address - Fax:
Practice Address - Street 1:2601COMPASS ROAD #140
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026
Practice Address - Country:US
Practice Address - Phone:847-503-0007
Practice Address - Fax:312-253-7244
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019298363LF0000X
IL209.019298363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily