Healthcare Provider Details

I. General information

NPI: 1801170642
Provider Name (Legal Business Name): ANGELA PURIC APN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2011
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 LEHIGH AVE
GLENVIEW IL
60026-1689
US

IV. Provider business mailing address

3406 LINNEMAN ST
GLENVIEW IL
60025-3922
US

V. Phone/Fax

Practice location:
  • Phone: 847-777-3807
  • Fax:
Mailing address:
  • Phone: 219-628-0698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number277.000036
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: