Individual
ANGEL NICOLE TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
500 N MICHIGAN AVE STE 1530, CHICAGO, IL 60611-3758
(630) 428-7890
Mailing address
8141 S MARSHFIELD AVE APT 3, CHICAGO, IL 60620-5791
(912) 580-9885
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
104100000X
Social Worker
Primary
150.104413
IL
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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