Provider Demographics
NPI:1245341536
Name:PADILLO, ERNESTO JAPOR (MD)
Entity type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:JAPOR
Last Name:PADILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12314 DAPHNE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142
Mailing Address - Country:US
Mailing Address - Phone:847-669-3081
Mailing Address - Fax:
Practice Address - Street 1:NORWEGIAN AMERICAN HOSPITAL 1022 N FRANCISCO
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622
Practice Address - Country:US
Practice Address - Phone:773-292-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36 48026207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036048026Medicaid
IL01638884OtherBLUE CROSS BLUE SHIELD
IL01638884OtherBLUE CROSS BLUE SHIELD
ILD12806Medicare UPIN