Provider Demographics
NPI:1184961526
Name:GOEBEL-ANGEL, MICHELLE HARMON (LAC, MSOM, MBA)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:HARMON
Last Name:GOEBEL-ANGEL
Suffix:
Gender:F
Credentials:LAC, MSOM, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3777
Mailing Address - Country:US
Mailing Address - Phone:312-276-1212
Mailing Address - Fax:
Practice Address - Street 1:500 N MICHIGAN AVE
Practice Address - Street 2:SUITE 450
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3777
Practice Address - Country:US
Practice Address - Phone:312-276-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000899171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist