Provider Demographics
NPI:1851823462
Name:CANO-GARCIA, ANGELA MARIA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIA
Last Name:CANO-GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 E 95TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-4804
Mailing Address - Country:US
Mailing Address - Phone:773-768-7700
Mailing Address - Fax:773-768-7768
Practice Address - Street 1:2231 E 95TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-4804
Practice Address - Country:US
Practice Address - Phone:773-768-7700
Practice Address - Fax:773-768-7768
Is Sole Proprietor?:No
Enumeration Date:2017-04-02
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036153293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine