Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD13547 | RI |
N | 208000000X | Pediatrician | TRN 12296 | FL |
Y | 2080P0205X | Pediatric Endocrinologist | 036135985 | IL |
NPI | 1093004079 |
---|---|
Provider Name | Angela Amelia Ganan Popa |
First Address | Hoffman Estates, IL 60169-1019 |
Second Address | Elk Grove Village, IL 60007-3397 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2011 |
Last Update Date | 29/12/2020 |