Provider Demographics
NPI:1871539668
Name:KABATAY, MARIA ESPERANZA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ESPERANZA
Last Name:KABATAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S 13TH ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554-4936
Mailing Address - Country:US
Mailing Address - Phone:309-353-0740
Mailing Address - Fax:309-353-0629
Practice Address - Street 1:600 S 13TH ST
Practice Address - Street 2:SUITE J
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-4936
Practice Address - Country:US
Practice Address - Phone:309-353-0740
Practice Address - Fax:309-353-0629
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09015685OtherBLUE CROSS BLUE SHIELD
IL335042Medicare PIN
D15897Medicare UPIN