Individual
CORNIE BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CNP
Contact information
Practice address
5140 N CALIFORNIA AVE, CHICAGO, IL 60625-3645
(872) 337-8500
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209027627
IL
Other
Enumeration date
08/16/2023
Last updated
05/28/2025
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