Individual provider Active NPI

Marc Kirit Balatero, MSN, RN, CNL

  • Community Health Registered Nurse
  • Chicago, IL
National Provider Identifier
1578446183
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
95112768 Issued in CA
Practice address
600 S Paulina St Ste 1080
Chicago, IL 60612-3806
Phone
(312) 942-7117
NPI assigned
Jul 30, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 95112768 CA Primary

Addresses

Primary practice location

600 S Paulina St Ste 1080
Chicago, IL 60612-3806

Mailing address

11224 Braddock Dr
Culver City, CA 90230-4807
Phone (310) 993-8618

Other practice location 1

3305 Bandini Blvd
Vernon, CA 90058-4130
Phone (310) 993-8618

Other practice location 2

901 W Hillcrest Blvd
Inglewood, CA 90301-2100
Phone (310) 993-8618

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)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
95112768CAMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1753833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1578446183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11224 BRADDOCK DR",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902304807",
            "telephone_number": "310-993-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST STE 1080",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "312-942-7117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3305 Bandini Blvd",
            "address_purpose": "LOCATION",
            "city": "Vernon",
            "state": "CA",
            "postal_code": "900584130",
            "country_code": "US",
            "telephone_number": "310-993-8618",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 W Hillcrest Blvd",
            "address_purpose": "LOCATION",
            "city": "Inglewood",
            "state": "CA",
            "postal_code": "903012100",
            "country_code": "US",
            "telephone_number": "310-993-8618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALATERO",
        "first_name": "MARC",
        "middle_name": "KIRIT",
        "credential": "MSN, RN, CNL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-30",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "95112768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; 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.