Individual
MS. ANGELA WILSON PENNISI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2929 N SOUTHPORT AVE, CHICAGO, IL 60657-6945
(773) 665-9950
(773) 665-9947
Mailing address
2929 N SOUTHPORT AVE, CHICAGO, IL 60657-6945
(773) 665-9950
(773) 665-9947
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-011327
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-011327
STATE LICENSE
IL
Enumeration date
01/11/2006
Last updated
10/30/2007
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