Provider Demographics
NPI:1861671372
Name:NAPERVILLE FAMILY PRACTICE INC
Entity Type:Organization
Organization Name:NAPERVILLE FAMILY PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BATHINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-355-8900
Mailing Address - Street 1:720 BROM CT
Mailing Address - Street 2:101
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6531
Mailing Address - Country:US
Mailing Address - Phone:630-355-8900
Mailing Address - Fax:630-355-8983
Practice Address - Street 1:720 BROM CT
Practice Address - Street 2:101
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6531
Practice Address - Country:US
Practice Address - Phone:630-355-8900
Practice Address - Fax:630-355-8983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1265548093OtherINDIVIDUAL NPI
IL208909OtherMEDICARE GROUP
IL02232550OtherBLUE CROSS
IL208909OtherMEDICARE GROUP