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Organization

BLENDING FAMILIES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATIE ANGEL L.C.P.C. (OWNER)
(847) 838-9904
Entity
Organization

Contact information

Practice address
800 MAIN ST, ANTIOCH, IL 60002-1542
(847) 838-9904
(847) 838-9907
Mailing address
800 MAIN ST, ANTIOCH, IL 60002-1542
(847) 838-9904
(847) 838-9907

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04932457
BLUE CROSS/SHIELD
IL
Enumeration date
08/12/2006
Last updated
07/23/2007
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