Provider Demographics
NPI:1376032250
Name:FALANA, ANGELLIE PHEAP (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ANGELLIE
Middle Name:PHEAP
Last Name:FALANA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ANGELLIE
Other - Middle Name:PHEAP
Other - Last Name:DAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:700 PASQUINELLI DRIVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559
Mailing Address - Country:US
Mailing Address - Phone:630-323-8690
Mailing Address - Fax:630-323-8657
Practice Address - Street 1:401 N MICHIGAN AVE STE 1200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4264
Practice Address - Country:US
Practice Address - Phone:312-635-0973
Practice Address - Fax:312-635-0050
Is Sole Proprietor?:No
Enumeration Date:2018-05-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041349825163W00000X
IL209015860363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse