Provider Demographics
NPI:1588857718
Name:WAANDERS, ANGELA (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:WAANDERS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:SIEVERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1000 S CLARK ST UNIT 1904
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2195
Mailing Address - Country:US
Mailing Address - Phone:215-687-9550
Mailing Address - Fax:
Practice Address - Street 1:225 E CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-227-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2019-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1479052080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology