| Doctor Name: | WILLIAM BAUTISTA |
| NPI Number: | 1023351376 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, LCSW |
| License Number: | 149015794 |
| Business Practice Address: | 2050 Larkin Ave Suite #202 Elgin, IL - 601234405 |
| Business Phone Number: | 8476972400 |
| Business Fax Number: | 8476972438 |
| Mailing Address: | 104 Glengarry Dr, #208 BLOOMINGDALE |
| State: | IL |
| Postal Code: | 601082603 |
| Phone Number: | 8476972400 |
| Fax Number: | 8476972438 |
| NPI Enumeration Date: | 04/04/2013 |
| NPI Last Update Date: | 04/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149015794 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |