Provider Demographics
NPI:1083680797
Name:SIMS, ANGELA B (LCSW)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:B
Last Name:SIMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 S STATE STREET
Mailing Address - Street 2:REVENUE #200 CHICAGO DEPARTMENT OF PUBLIC HEALTH
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604
Mailing Address - Country:US
Mailing Address - Phone:312-747-9443
Mailing Address - Fax:312-747-9447
Practice Address - Street 1:333 S STATE ST
Practice Address - Street 2:REVENUE #200 CHICAGO DEPARTMENT OF PUBLIC HEALTH
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604
Practice Address - Country:US
Practice Address - Phone:312-747-9442
Practice Address - Fax:312-747-9447
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149005854104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL971950Medicare ID - Type Unspecified