# CHAD TATTINI, MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598951063
- **Authorized official:** MRS. NICHOLE BARNETT (PRACTICE MANAGER)
- **Authorized official phone:** (309) 664-1007

## Contact information

- **Practice address:** 2502 C EMPIRE STREET, BLOOMINGTON, IL 61704
- **Practice address phone:** (309) 664-1007
- **Practice address fax:** (309) 664-5006
- **Mailing address:** 2502-C EMPIRE STREET, BLOOMINGTON, IL 61704
- **Mailing address phone:** (309) 664-1007
- **Mailing address fax:** (309) 664-5006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 036110975 | IL | Yes |

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 07/16/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036110975 | — | IL |
| 01 | — | 094439 | HEALTH ALLIANCE | IL |
| 01 | — | 5732052 | BLUE CROSS BLUE SHIELD | IL |
| 01 | — | 681561 | HEALTH LINK | IL |
| 01 | — | P00169439 | RAILROAD MEDICARE | IL |