Provider Demographics
NPI:1689650087
Name:BALADAD, JUANITO T (MD)
Entity Type:Individual
Prefix:DR
First Name:JUANITO
Middle Name:T
Last Name:BALADAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1730 PARK ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2688
Mailing Address - Country:US
Mailing Address - Phone:630-718-0200
Mailing Address - Fax:630-718-0900
Practice Address - Street 1:1730 PARK ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2688
Practice Address - Country:US
Practice Address - Phone:630-718-0200
Practice Address - Fax:630-718-0900
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2023-09-06
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Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C42323Medicare UPIN