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General NPI Number Information
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NPI Number | 1780270603
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Entity Type | Organization
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Legal Business Name | THE ANGELO METHOD TAM INC
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Dates
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Enumeration Date | 12/15/2020
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Last Update Date | 12/15/2020
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Provider Practice Location Address
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Address Line | 1320 CHASE ST STE 1A
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City | ALGONQUIN
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State | IL
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Zip | 60102-9668
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Country | US
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Telephone | 312-448-3064
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Fax | 708-366-2180
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Provider Business Mailing Address
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Address Line | 1320 CHASE ST STE 1A
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City | ALGONQUIN
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State | IL
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Zip | 60102-9668
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Country | US
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Telephone | 312-448-3064
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Fax | 708-366-2180
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICK ANGELO JR.
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Credential | MD
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Telephone | 312-448-3064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 132700000X
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Taxonomy Name | Dietary Manager
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 133VN1101X
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Taxonomy Name | Gerontological Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 133VN1501X
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Taxonomy Name | Sports Dietetics Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 136A00000X
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Taxonomy Name | Registered Dietetic Technician
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License Number |
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License Number State |
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