Healthcare Provider Details

I. General information

NPI: 1124686993
Provider Name (Legal Business Name): ANGELICA DELGADO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 S RIVER ST
AURORA IL
60506-5185
US

IV. Provider business mailing address

70 S RIVER ST
AURORA IL
60506-5185
US

V. Phone/Fax

Practice location:
  • Phone: 630-844-2662
  • Fax:
Mailing address:
  • Phone: 630-844-2662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: