Provider Demographics
NPI:1508116021
Name:WEEDEN, ANGELA MARIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:MARIE
Last Name:WEEDEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9325 S VANDERPOEL AVE
Mailing Address - Street 2:2ND FLOOR FRONT
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-5817
Mailing Address - Country:US
Mailing Address - Phone:630-460-4591
Mailing Address - Fax:
Practice Address - Street 1:9325 S VANDERPOEL AVE
Practice Address - Street 2:2ND FLOOR FRONT
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-5817
Practice Address - Country:US
Practice Address - Phone:630-460-4591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker