Healthcare Provider Details

I. General information

NPI: 1093010241
Provider Name (Legal Business Name): ANGELA MICHELLE CONWAY PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2011
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28W530 BATAVIA RD STE 1A
WARRENVILLE IL
60555-3022
US

IV. Provider business mailing address

28W530 BATAVIA RD STE 1A
WARRENVILLE IL
60555-3022
US

V. Phone/Fax

Practice location:
  • Phone: 630-292-0029
  • Fax:
Mailing address:
  • Phone: 630-292-0029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071008483
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: