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NPI Code Detail

MEDICARE: DR. ANGELA SEDENO PH.D.

MEDICARE: DR. ANGELA SEDENO PH.D.
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
1103TC0700XClinical Psychologist071008006IL
2103TC2200XClinical Child & Adolescent Psychologist071008006IL
3103TF0000XFamily Psychologist071008006IL

General Provider Information

NPI Number : 1609177237
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA SEDENO PH.D.
Provider Business Mailing Address
First Line : 1100 S HAMILTON AVE
Second Line : MEDICAL
City : CHICAGO
State : IL
Zip : 60612-4207
Country : US
Telephone Number : 773-919-9116
Fax Number :
Provider Business Practice Location Address
First Line : 1100 S HAMILTON AVE
Second Line : MEDICAL
City : CHICAGO
State : IL
Zip : 60612-4207
Country : US
Telephone Number : 312-433-7106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2010
Last Update Date : 11/12/2010

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Directions to “ DR. ANGELA SEDENO PH.D.” Practice Location

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