Joanne Sim Bavelis, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085001689 Issued in IL

Practice address

676 N Saint Clair St
19TH Floor
Chicago, IL 60611-2927

Phone

(312) 926-3205

Fax

(312) 695-0042

NPI assigned

Sep 8, 2005

Last updated

Dec 29, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844
  NPD (past)
• Illinois Gastroenterology Institute, PLLC

  • Gastroenterology Physician
  • Peoria, IL
  • NPI 1275575706
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1063406718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N MICHIGAN AVE",
            "address_2": "APT 2301",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112617",
            "telephone_number": "850-543-8906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST",
            "address_2": "19TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112927",
            "telephone_number": "312-926-3205",
            "fax_number": "312-695-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAVELIS",
        "first_name": "JOANNE",
        "middle_name": "SIM",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085001689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "776530",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine L Bautista
• Maria Riza De Guzman Bautista, MD
• Michelle Martha Bautista, LCSW
• Miguel Bautista, CADC
• Joseph Bradley Bavaro, MD
• Margaret Bavis
• Aakash Bavishi, MD
• Pranavi Sanka Bavishi
• Aasheeta Arun Parikh Bawa, PA-C
• Inderjit Bawa, DDS

• Medical Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.