Individual
ANGELA S THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1065 E 9TH ST, LOCKPORT, IL 60441-3567
(815) 588-1366
(815) 588-2010
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-015115
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00865614
MEDICARE RR
IL
Enumeration date
05/29/2008
Last updated
12/09/2010
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