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General NPI Number Information
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NPI Number | 1770711434
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Entity Type | Individual
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Provider Name | CHRISTIAN P BADILLO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 10/21/2013
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Provider Practice Location Address
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Address Line | 4440 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2600
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Country | US
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Telephone | 708-684-5375
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 S CALUMET AVE UNIT 1207
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City | CHICAGO
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State | IL
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Zip | 60616-6009
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Country | US
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Telephone | 773-208-3001
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036.129073
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01072860A
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License Number State | IN
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