Individual provider Active NPI

Bonnafe I Baticados, BSN, RN, WCC

  • Wound Care Registered Nurse
  • Woodridge, IL
National Provider Identifier
1194193920
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
License
041.280969 Issued in IL
Practice address
3241 Justamere Rd
Woodridge, IL 60517-3759
Phone
(630) 544-8517
NPI assigned
Sep 10, 2015
Last updated
Sep 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X 041.280969 IL Primary

Addresses

Primary practice location

3241 Justamere Rd
Woodridge, IL 60517-3759

Mailing address

3241 Justamere Rd
Woodridge, IL 60517-3759
Phone (630) 544-8517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041.280969ILMDWound Care Registered Nurse

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1194193920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 JUSTAMERE RD",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605173759",
            "telephone_number": "630-544-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 JUSTAMERE RD",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605173759",
            "telephone_number": "630-544-8517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATICADOS",
        "first_name": "BONNAFE",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "BSN, RN, WCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "IL",
            "license": "041.280969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.