Prosise, Angela M

Prosise, Angela M is an individual health care provider with primary practice located at 619 E Mason St Suite 4P57, Springfield IL 62701-1034. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Prosise, Angela M can be contacted via phone (217) 788-0706.

Contact Information

Primary practice address
619 E Mason St Suite 4P57 Springfield IL 62701-1034
Phone: (217) 788-0706
Fax: (217) 525-2535
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 085-002151 Illinois

Profile Details

NPI number 1578647947
LBN Legal business name Prosise, Angela M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2006
Last updated Mar 21st, 2012 - about 14 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 1578647947 NPPES
Illinois Other P00092459 RAILROAD

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