Provider Demographics
NPI:1316388796
Name:BATISTA, JOSEFINA (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEFINA
Middle Name:
Last Name:BATISTA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 N PARK DR APT 3904
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-0014
Mailing Address - Country:US
Mailing Address - Phone:352-804-2692
Mailing Address - Fax:
Practice Address - Street 1:2850 W 95TH ST STE 400
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2755
Practice Address - Country:US
Practice Address - Phone:708-424-7600
Practice Address - Fax:708-424-7605
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036144838208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036144838Medicaid