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General NPI Number Information
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NPI Number | 1891479119
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Entity Type | Individual
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Provider Name | ANGIE KALWIES CGC
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Gender | Female
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST
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City | CHICAGO
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State | IL
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Zip | 60612-3841
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Country | US
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Telephone | 312-942-1632
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Fax |
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Provider Business Mailing Address
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Address Line | 412 N TAYLOR AVE APT 3F
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City | OAK PARK
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State | IL
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Zip | 60302-2425
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Country | US
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Telephone | 319-331-9824
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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 | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | 74000596A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | 246000919
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License Number State | IL
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