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General NPI Number Information
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NPI Number | 1184972622
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Entity Type | Individual
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Provider Name | GEORGIA ANGELAKOS L.C.P.C.
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Gender | Female
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 5406 W DEVON AVE RM 202A
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City | CHICAGO
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State | IL
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Zip | 60646-4146
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Country | US
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Telephone | 312-804-9649
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Fax |
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Provider Business Mailing Address
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Address Line | 7902 N NEVA AVE
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City | NILES
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State | IL
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Zip | 60714-3212
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Country | US
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Telephone | 312-804-9649
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.008329
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180008329
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License Number State | IL
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