Provider Demographics
NPI:1740759612
Name:RATCLIFFE, ANGELA J
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:J
Last Name:RATCLIFFE
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 1:2215 W 95TH ST # 100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-1001
Mailing Address - Country:US
Mailing Address - Phone:773-239-9600
Mailing Address - Fax:773-239-9601
Practice Address - Street 1:2215 W 95TH ST # 100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1001
Practice Address - Country:US
Practice Address - Phone:773-239-9600
Practice Address - Fax:773-239-9601
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health