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Individual

ANGELO MIELE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
501 THORNHILL DR, CAROL STREAM, IL 60188-2793
(630) 668-3210
(630) 668-3505
Mailing address
501 THORNHILL DR, CAROL STREAM, IL 60188-2793
(630) 668-3210
(630) 668-3505

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036064705
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036064705
IL
01
920540
MEDICARE GROUP PTAN
IL
01
CA4748
MEDICARE GROUP RR PTAN
IL
01
F400137214
MEDICARE INDIVIDUAL PTAN
IL
01
P01328176
MEDICARE INDIVIDUAL RR PTAN
IL
Enumeration date
09/16/2006
Last updated
06/24/2016
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