Individual
BELLA Y PADAOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(708) 783-2450
Mailing address
PO BOX 486, LAKE FOREST, IL 60045
(800) 444-6110
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
041-172412
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209001499
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-172412
STATE LICENSE
IL
05
—
209001499
—
IL
Enumeration date
10/18/2006
Last updated
06/01/2022
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