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PATRICIA M BALTAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
410 E LINCOLN HWY STE 101, NEW LENOX, IL 60451-1976
(815) 462-5544
Mailing address
25138 ROCKWELL LN, PLAINFIELD, IL 60585-2236
(708) 903-0998

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
209025045
IL
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
Primary
036117307
IL

Other

Enumeration date
08/05/2022
Last updated
10/28/2022
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