Individual
DR. EDWIN BAUTISTA PASCUAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5103 W CERMAK RD, CICERO, IL 60804-2902
(708) 780-7400
(708) 780-7423
Mailing address
1331 W HORSESHOE CT, ADDISON, IL 60101-3146
(708) 780-7400
(708) 780-7423
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036067770
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031601680
BCBS
IL
05
—
036067770
—
IL
Enumeration date
08/31/2006
Last updated
03/17/2025
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