Provider Demographics
NPI:1619539228
Name:PADAO, AIEDEN G (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:AIEDEN
Middle Name:G
Last Name:PADAO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9905 BEDFORD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-2305
Mailing Address - Country:US
Mailing Address - Phone:708-545-8846
Mailing Address - Fax:
Practice Address - Street 1:455 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-1529
Practice Address - Country:US
Practice Address - Phone:708-545-8846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019425363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily