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General NPI Number Information
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NPI Number | 1023817905
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Entity Type | Individual
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Provider Name | PAULA ANGELES MARCIAL APRN
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Gender | Female
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1431 MCHENRY RD STE 105
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-1378
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Country | US
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Telephone | 832-869-4818
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Fax |
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Provider Business Mailing Address
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Address Line | 134 AUGUSTA DR
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City | STREAMWOOD
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State | IL
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Zip | 60107-1288
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Country | US
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Telephone | 224-636-1352
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209031903
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License Number State | IL
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