Individual
ANGELA B DANIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
144 NORTH CT, DIXON, IL 61021
(815) 285-5437
(815) 285-8928
Mailing address
144 NORTH CT, DIXON, IL 61021-1224
(815) 285-5437
(815) 285-8928
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-003360
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400262366
MEDICARE
IL
Enumeration date
11/07/2008
Last updated
09/12/2018
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