Provider Demographics
NPI:1386832400
Name:LANG, ANGELA MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:LANG
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2525 KANEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2578
Mailing Address - Country:US
Mailing Address - Phone:630-584-1400
Mailing Address - Fax:630-584-1733
Practice Address - Street 1:2525 KANEVILLE RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-2578
Practice Address - Country:US
Practice Address - Phone:630-584-1400
Practice Address - Fax:630-584-1733
Is Sole Proprietor?:No
Enumeration Date:2007-10-15
Last Update Date:2021-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL085003095363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant