Provider Demographics
NPI:1144478173
Name:ANGELILLI, ADAM T (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:T
Last Name:ANGELILLI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1010 W FAIRWAY DR
Mailing Address - Street 2:2ND FLOOR (PEDIATRICS)
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-6600
Mailing Address - Country:US
Mailing Address - Phone:815-599-7755
Mailing Address - Fax:815-599-7627
Practice Address - Street 1:1010 W FAIRWAY DR
Practice Address - Street 2:2ND FLOOR (PEDIATRICS)
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-6600
Practice Address - Country:US
Practice Address - Phone:815-599-7755
Practice Address - Fax:815-599-7627
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2011-06-01
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Provider Licenses
StateLicense IDTaxonomies
IL036.122065208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics