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General NPI Number Information
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NPI Number | 1710784244
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Entity Type | Individual
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Provider Name | CRYSTAL PADILLA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 661 N WELLS ST
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City | CHICAGO
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State | IL
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Zip | 60654-3616
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Country | US
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Telephone | 312-589-7620
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Fax |
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Provider Business Mailing Address
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Address Line | 804 SHANNON LAKE CT
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City | WESTMONT
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State | IL
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Zip | 60559-2593
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 051306892
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License Number State | IN
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