Individual
MRS. JACQUELINE ANN BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 N BERTEAU AVE, ELMHURST, IL 60126-2966
(630) 833-1400
(630) 941-4597
Mailing address
4423 N NEW ENGLAND AVE, HARWOOD HEIGHTS, IL 60706-4825
(312) 543-3348
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
018206
IL
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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