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NPI Code Detail

MEDICARE: KEVIN ANGULO LPC

MEDICARE: KEVIN ANGULO LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor178.017553IL

General Provider Information

NPI Number : 1275256398
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN ANGULO LPC
Provider Business Mailing Address
First Line : 3249 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60634-4360
Country : US
Telephone Number : 773-371-3700
Fax Number :
Provider Business Practice Location Address
First Line : 3249 N CENTRAL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60634-4360
Country : US
Telephone Number : 773-371-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2022
Last Update Date : 02/03/2026

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Directions to “ KEVIN ANGULO LPC” Practice Location

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