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Individual

DR. ANGELA M HENDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1987 W 111TH ST, CHICAGO, IL 60643-4247
(773) 238-1100
(773) 238-4095
Mailing address
10755 S SEELEY AVE, CHICAGO, IL 60643-3314
(312) 752-6289

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
041245406
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.025817
IL

Other

Enumeration date
03/08/2022
Last updated
08/29/2022
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