Healthcare Provider Details

I. General information

NPI: 1609783646
Provider Name (Legal Business Name): ANGELICA BACA ADAME LICENSED SOCIAL WORK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 NATIONAL PKWY STE 20
SCHAUMBURG IL
60173-5150
US

IV. Provider business mailing address

129 CORNERSTONE DR
HAMPSHIRE IL
60140-0287
US

V. Phone/Fax

Practice location:
  • Phone: 847-807-6155
  • Fax: 630-328-0114
Mailing address:
  • Phone: 224-245-2390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150130231
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: