Provider Demographics
NPI:1023428448
Name:BATTIN, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BATTIN
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 1:675 N SAINT CLAIR ST STE 17-250
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5962
Mailing Address - Country:US
Mailing Address - Phone:312-695-2300
Mailing Address - Fax:312-695-2543
Practice Address - Street 1:675 N SAINT CLAIR ST STE 17-250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5962
Practice Address - Country:US
Practice Address - Phone:312-695-2300
Practice Address - Fax:312-695-2543
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164.004527133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered