Individual
ANGELA BANKS-STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1013 ASHLAND AVE, EVANSTON, IL 60202-1138
(847) 859-6393
Mailing address
1013 ASHLAND AVE, EVANSTON, IL 60202-1138
(847) 859-6393
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146.010898
IL
235Z00000X
Speech-Language Pathologist
22003824A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11512055
CAQH
IN
Enumeration date
01/24/2008
Last updated
06/19/2013
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