Provider Information for 1972256394
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Mr. KYLE BRAND PADILLA LCSW
Sex: Male
NPI: 1972256394
Last Updated: 2024-09-24
Certification Date: 2024-09-24
Certification Date: 2024-09-24
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1972256394 | ||||||||
| Enumeration Date | 2022-01-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 111 W JACKSON BLVD STE 1700 CHICAGO, IL 60604-3597 United States Phone: 646-453-6777 | Fax:833-900-1747 | ||||||||
| Primary Practice Address | 111 W JACKSON BLVD STE 1700 CHICAGO, IL 60604-3597 United States Phone: 646-453-6777 | Fax:833-900-1747 | ||||||||
| Secondary Practice Address(es) | 710 S PAULINA ST STE 438 | ||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|