Provider Demographics
NPI:1922161827
Name:BATTISTINI, JOSE F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:F
Last Name:BATTISTINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6590
Mailing Address - Country:US
Mailing Address - Phone:815-729-0330
Mailing Address - Fax:815-729-0566
Practice Address - Street 1:301 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6590
Practice Address - Country:US
Practice Address - Phone:815-729-0330
Practice Address - Fax:815-729-0566
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09908558OtherBCBS
IL1639359797OtherGROUP NPI
ILE63413Medicare UPIN
IL1639359797OtherGROUP NPI