Pascual, Edwin Bautista

Pascual, Edwin Bautista is an sole proprietor health care provider with primary practice located at 4941 W 14Th St , Cicero IL 60804-1419. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Pascual, Edwin Bautista can be contacted via phone (708) 780-7400.

Contact Information

Primary practice address
4941 W 14Th St Cicero IL 60804-1419
Phone: (708) 780-7400
Fax: (708) 780-7423
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036067770 Illinois

Profile Details

NPI number 1326159104
LBN Legal business name Pascual, Edwin Bautista
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 31st, 2006
Last updated Nov 2nd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326159104 NPPES
Illinois MEDICAID 036067770
Illinois Other 0031601680

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