Healthcare Provider Details

I. General information

NPI: 1457217754
Provider Name (Legal Business Name): JESSICA D'ANGELO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N MICHIGAN AVE STE 810
CHICAGO IL
60601-5902
US

IV. Provider business mailing address

205 N MICHIGAN AVE STE 810
CHICAGO IL
60601-5902
US

V. Phone/Fax

Practice location:
  • Phone: 312-600-0203
  • Fax:
Mailing address:
  • Phone: 312-600-0203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JESSICA D'ANGELO
Title or Position: OWNER, MANAGER
Credential: NP
Phone: 312-600-0203