Active NPI
Jacqueline Bautista
- Social Worker
- Westmont, IL
National Provider Identifier
1831948900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 1501147
- Practice address
- 414 Plaza Dr Ste 301
Westmont, IL 60559-5508 - Phone
- (630) 728-1744
- NPI assigned
- May 13, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 1501147 | IL | Primary |
Addresses
Primary practice location
414 Plaza Dr Ste 301
Westmont, IL 60559-5508
Mailing address
414 Plaza Dr Ste 301
Westmont, IL 60559-5508
Phone (630) 728-1744
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1501147 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776211200000",
"number": "1831948900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 PLAZA DR STE 301",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605595508",
"telephone_number": "630-728-1744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 PLAZA DR STE 301",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605595508",
"telephone_number": "630-728-1744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA",
"first_name": "JACQUELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-13",
"last_updated": "2026-04-15",
"certification_date": "2026-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "1501147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westmont, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.