Provider Demographics
NPI:1578337028
Name:RABAGO VEGA, ANGELI
Entity Type:Individual
Prefix:
First Name:ANGELI
Middle Name:
Last Name:RABAGO VEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14B E DUNDEE QUARTER DR UNIT 101
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-1620
Mailing Address - Country:US
Mailing Address - Phone:606-669-7809
Mailing Address - Fax:
Practice Address - Street 1:14B E DUNDEE QUARTER DR UNIT 101
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-1620
Practice Address - Country:US
Practice Address - Phone:606-669-7809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician