Provider Demographics
NPI:1598262594
Name:BABUJI, ANGELINE (DO)
Entity Type:Individual
Prefix:
First Name:ANGELINE
Middle Name:
Last Name:BABUJI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2923 N CALIFORNIA AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-7702
Mailing Address - Country:US
Mailing Address - Phone:773-463-3460
Mailing Address - Fax:
Practice Address - Street 1:2923 N CALIFORNIA AVE STE 200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7702
Practice Address - Country:US
Practice Address - Phone:773-463-3460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-07
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036156893207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine