Healthcare Provider Details

I. General information

NPI: 1952492829
Provider Name (Legal Business Name): ISABELLE KRISTEN BADILLO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 BARRINGTON RD 605
HOFFMAN ESTATES IL
60169-1090
US

IV. Provider business mailing address

1585 BARRINGTON RD 605
HOFFMAN ESTATES IL
60169-1090
US

V. Phone/Fax

Practice location:
  • Phone: 847-755-1111
  • Fax: 847-755-1166
Mailing address:
  • Phone: 847-755-1111
  • Fax: 847-755-1166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number010044
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085002906
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: