MEDICARE: MS. ANGELA L GILLIAM

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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1295238475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELA L GILLIAM

Provider Business Mailing Address
First Line	:	4610 S LAVERGNE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-2006
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4610 S LAVERGNE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-2006
Country	:	US
Telephone Number	:	312-593-2631
Fax Number	:

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

Provider Enumeration Date	:	03/14/2018
Last Update Date	:	03/14/2018

Similar Medicare Providers

1255659504 — MRS. CATHERINE RENE LARSON ILTYPE 10, LBS1
Practice Location Address:

1806 W SCHOOL ST , APARTMENT 2
CHICAGO, IL
60657-2006

Practice Phone: 773-404-3069
Practice Fax:

1669083424 — LINDSAY MINER
Practice Location Address:

2272 W LELAND AVE # 1E
CHICAGO, IL
60625-2006

Practice Phone: 309-825-4025
Practice Fax:

1699065813 — PRIMO CENTER FOR WOMEN AND CHILDREN
Practice Location Address:

6212 S SANGAMON ST
CHICAGO, IL
60621-2006

Practice Phone: 773-826-7991
Practice Fax: 773-471-6099

1255739165 — HELEN MUJICA CNA
Practice Location Address:

2006 24TH ST
NORTH CHICAGO, IL
60064-3128

Practice Phone: 224-302-2727
Practice Fax:

1619341112 — LS SURGERY CENTER LTD
Practice Location Address:

2006 N PULASKI RD
CHICAGO, IL
60639-3767

Practice Phone: 773-772-8876
Practice Fax:

1366981300 — HERMOSA PHARMACY INC
Practice Location Address:

2006 N PULASKI RD
CHICAGO, IL
60639

Practice Phone: 773-227-1211
Practice Fax:

Directions to “ MS. ANGELA L GILLIAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.