Provider Demographics
NPI:1831653690
Name:CHATMAN, BIANCA
Entity Type:Individual
Prefix:MRS
First Name:BIANCA
Middle Name:
Last Name:CHATMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6413 BRIDLE PATH DR
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-3344
Mailing Address - Country:US
Mailing Address - Phone:708-937-2263
Mailing Address - Fax:
Practice Address - Street 1:4801 SAUK TRL UNIT B
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-1017
Practice Address - Country:US
Practice Address - Phone:708-773-1643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28204939A163W00000X, 363LF0000X
IL277.001938363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse