Provider Demographics
NPI:1043872112
Name:BAITY, CHENA (BACHELORS, MASTERS,)
Entity type:Individual
Prefix:MRS
First Name:CHENA
Middle Name:
Last Name:BAITY
Suffix:
Gender:F
Credentials:BACHELORS, MASTERS,
Other - Prefix:MRS
Other - First Name:CHENA
Other - Middle Name:
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CHENA TURNER
Mailing Address - Street 1:PO BOX 598
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-0598
Mailing Address - Country:US
Mailing Address - Phone:708-316-8724
Mailing Address - Fax:815-409-7926
Practice Address - Street 1:629 NORTHGATE LN
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60404-9551
Practice Address - Country:US
Practice Address - Phone:708-316-8724
Practice Address - Fax:815-409-7926
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043069407164W00000X
IL343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No164W00000XNursing Service ProvidersLicensed Practical Nurse