Heather Bautista, LDN, N.D., CNS

Primary specialty

NutritionistTaxonomy code 133N00000X

License

164.006893 Issued in IL

Practice address

1200 S York St
Suite 1132
Elmhurst, IL 60126-5626

Phone

(331) 221-6135

NPI assigned

Oct 5, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

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

• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD (past)
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  NPD (past)

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1265982003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST",
            "address_2": "SUITE 1132",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265626",
            "telephone_number": "331-221-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST",
            "address_2": "SUITE 1132",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265626",
            "telephone_number": "331-221-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "HEATHER",
        "name_prefix": "Mrs.",
        "credential": "LDN, N.D., CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "IL",
            "license": "164.006893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Barton
• Eugene J Bartucci, MD
• Kathryn Baubly
• Paul Michael Baubly, MD
• Christian Bautista, M.D
• Jacqueline Ann Bautista, CRNA
• Be Well Chiropractic Clinics LLC
• Beams Technologies, Inc.
• Donald Christie Beard, DDS
• Emily Becker

• Nutritionist in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• Nutritionist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2016; 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.