Provider Demographics
NPI:1790069540
Name:BATLEY, CHAKA K (DNP, FPA-APRN, PMHNP)
Entity Type:Individual
Prefix:DR
First Name:CHAKA
Middle Name:K
Last Name:BATLEY
Suffix:
Gender:F
Credentials:DNP, FPA-APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 N COUNTY ROAD 2050 E
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:IL
Mailing Address - Zip Code:62321-3551
Mailing Address - Country:US
Mailing Address - Phone:217-357-6888
Mailing Address - Fax:217-357-6889
Practice Address - Street 1:1450 N COUNTY ROAD 2050 E
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:IL
Practice Address - Zip Code:62321-3551
Practice Address - Country:US
Practice Address - Phone:217-357-6888
Practice Address - Fax:217-357-6889
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020005254363LP0200X
IL277000002363LP0200X, 363LP0808X
MO2020005255363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2020005255OtherCERTIFIED NURSE PRACTITIONER: FAMILY PSYCHIATRIC AND MENTAL HEALTH
IL277000002OtherAPRN FPA
MO2020005254OtherCERTIFIED NURSE PRACTITIONER : PEDIATRICS