Provider Demographics
NPI:1841871407
Name:PADILLA, CINDY IRENE (CNA)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:IRENE
Last Name:PADILLA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17551 COMMUNITY ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-2012
Mailing Address - Country:US
Mailing Address - Phone:773-431-1778
Mailing Address - Fax:
Practice Address - Street 1:17551 COMMUNITY ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-2012
Practice Address - Country:US
Practice Address - Phone:773-431-1778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0000000000376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide