Provider Demographics
NPI:1932077203
Name:CARILLO, MAY ANGELINE OBANIL
Entity type:Individual
Prefix:
First Name:MAY ANGELINE
Middle Name:OBANIL
Last Name:CARILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:MAY ANGELINE
Other - Last Name:CARILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:128 STIRLING CT
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-4361
Mailing Address - Country:US
Mailing Address - Phone:989-225-7719
Mailing Address - Fax:989-225-7719
Practice Address - Street 1:128 STIRLING CT
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-4361
Practice Address - Country:US
Practice Address - Phone:989-225-7719
Practice Address - Fax:989-225-7719
Is Sole Proprietor?:No
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker