Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 036149321 | IL |
N | 207K00000X | Allergist & Immunologist | 65373-20 | WI |
NPI | 1184967770 |
---|---|
Provider Name | Evelyn Lizbeth Angulo |
First Address | Glenview, IL 60026-1324 |
Second Address | Glenview, IL 60026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2013 |
Last Update Date | 12/10/2021 |