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Individual

AIDA I BADILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
7900 SHELBYVILLE RD STE A15, LOUISVILLE, KY 40222-5463
(502) 327-8568
(502) 327-0613
Mailing address
5855 RELIABLE PKWY, CHICAGO, IL 60686-0001
(502) 955-2020
(502) 736-4490

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1471DT
KY
152W00000X
Optometrist
18003026
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200312800
IN
05
77000305
KY
Enumeration date
07/05/2005
Last updated
06/26/2019
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