Provider Demographics
NPI:1689131369
Name:PERALEZ, ANGELINA (CADC)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:PERALEZ
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 LOVELAND CT
Mailing Address - Street 2:
Mailing Address - City:GILBERTS
Mailing Address - State:IL
Mailing Address - Zip Code:60136-4043
Mailing Address - Country:US
Mailing Address - Phone:847-217-6112
Mailing Address - Fax:
Practice Address - Street 1:2 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-4341
Practice Address - Country:US
Practice Address - Phone:847-742-3545
Practice Address - Fax:847-742-3559
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)