Provider Demographics
NPI:1538988639
Name:MCNEILL, ANGELA D
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 N SWIFT RD
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-6105
Mailing Address - Country:US
Mailing Address - Phone:877-751-5783
Mailing Address - Fax:
Practice Address - Street 1:1221 N SWIFT RD
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-6105
Practice Address - Country:US
Practice Address - Phone:877-751-5783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMCNE-J9BHR363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily