Provider / Organization | NPI | Date Certified |
---|---|---|
SUZANNE MARIE DIBATTISTA | 1831657824 | 2022-06-19 |
Suzanne Marie Dibattista is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1831657824. Registration indicates Suzanne Marie Dibattista is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Pediatrics) (Allopathic & Osteopathic Physicians, Pediatrics) (Pediatrics, ) (Primary Care/Family Planning/APRN/PA, ) (Pediatrics, Allopathic & Osteopathic Physicians)
Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
Entity Type | Individual |
Provider Name | Suzanne Marie Dibattista MD |
Practice Office Address | 1645 W JACKSON BLVD STE 200 CHICAGO, IL US |
Practice Office Telephone | 3129422200 |
Mailing Address | 1645 W JACKSON BLVD STE 200 CHICAGO, IL 606123227 US |
Business Telephone | 3129422000 |
Code | Practice | License No State |
---|---|---|
390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
208000000X PRIMARY | Access to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Pediatrics Allopathic & Osteopathic Physicians Pediatrics Pediatrics Primary Care/Family Planning/APRN/PA Pediatrics Allopathic & Osteopathic Physicians | 036.159318
IL |