MEDICARE: ANGELICA MARIA MIRANDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor		IL

General Provider Information

NPI Number	:	1083546956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA MARIA MIRANDA

Provider Business Mailing Address
First Line	:	6117 S GREENWOOD AVE # 4
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-2721
Country	:	US
Telephone Number	:	608-698-4008
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 N MICHIGAN AVE # 500C
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-7511
Country	:	US
Telephone Number	:	312-620-7551
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ ANGELICA MARIA MIRANDA ” Practice Location

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