Individual provider · NPI-1

Swati Bavisi, RN, MS, CPNP, APN

Nurse Practitioner, Pediatrics · Park Ridge, IL

NPI number1730381302
StatusActive
Last updated in NPPESDec 8, 2021

Details

NPI
1730381302
Entity type
Individual (NPI-1)
Name
Ms. Swati Bavisi
Credential
RN, MS, CPNP, APN
Sex
Female
Sole proprietor
No
Enumeration date
Jun 4, 2007
Certification date
Dec 2, 2021
Last updated
Dec 8, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics209006530ILYes

Practice location

1775 Dempster St
Park Ridge, IL 60068-1143

Phone 847-723-5043

Mailing address

757 W Liberty St
307
Chicago, IL 60607-5018

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