Individual
ELIZABETH E DEANGELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3811 VALLEY CENTRE DR, SAN DIEGO, CA 92130-3318
(773) 641-2074
Mailing address
833 W PEREGRINE DR, PALATINE, IL 60067-7048
(773) 641-2074
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209008577
IL
363LP0200X
Pediatric Nurse Practitioner
Primary
95003684
CA
Other
Enumeration date
04/04/2011
Last updated
03/28/2017
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