Gillham, Angela Deon

Gillham, Angela Deon is an individual health care provider with primary practice located at 800 W 5Th Ave 100G, Naperville IL 60563-8965. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gillham, Angela Deon can be contacted via phone (312) 498-4113.

Contact Information

Primary practice address
800 W 5Th Ave 100G Naperville IL 60563-8965
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X Illinois

Profile Details

NPI number 1194878405
LBN Legal business name Gillham, Angela Deon
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194878405 NPPES
Illinois Other 2232522 BLUE CROSS BLUE SHIELD
Illinois Other 2254200 BLUE CROSS BLUE SHIELD
Illinois Other 266818 BLUE CROSS BLUE SHIELD

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