Provider Demographics
NPI:1316951742
Name:CORPUZ-BATO, MARIA FE (DMD)
Entity type:Individual
Prefix:
First Name:MARIA FE
Middle Name:
Last Name:CORPUZ-BATO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 N RIVERSIDE DR
Mailing Address - Street 2:SUITE 211
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5908
Mailing Address - Country:US
Mailing Address - Phone:847-336-3770
Mailing Address - Fax:
Practice Address - Street 1:495 N RIVERSIDE DR
Practice Address - Street 2:SUITE 211
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5908
Practice Address - Country:US
Practice Address - Phone:847-336-3770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice