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General NPI Number Information
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NPI Number | 1588857718
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Entity Type | Individual
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Provider Name | ANGELA WAANDERS M.D., MPH
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Gender | Female
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 01/06/2019
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Provider Practice Location Address
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Address Line | 225 E CHICAGO AVE
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City | CHICAGO
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State | IL
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Zip | 60611
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Country | US
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Telephone | 312-227-4090
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 S CLARK ST UNIT 1904
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City | CHICAGO
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State | IL
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Zip | 60605-2195
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Country | US
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Telephone | 215-687-9550
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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 | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 036.147905
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License Number State | IL
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