Individual
DR. HEATHER N PADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, BLDG 110, ROOM 3225, MAYWOOD, IL 60153-3328
(708) 327-2697
(708) 327-3565
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 327-2697
(708) 327-3565
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
036.129011
IL
2086S0120X
Pediatric Surgery Physician
2009-02086
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5914201
—
IL
Enumeration date
07/05/2007
Last updated
04/30/2012
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