Provider Demographics
NPI:1205978475
Name:CROWLEY, ANGELA R (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:R
Last Name:CROWLEY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:R
Other - Last Name:TUBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:535 PLAINFIELD RD STE D
Mailing Address - Street 2:
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7608
Mailing Address - Country:US
Mailing Address - Phone:630-277-9018
Mailing Address - Fax:866-531-8584
Practice Address - Street 1:535 PLAINFIELD RD STE D
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-7608
Practice Address - Country:US
Practice Address - Phone:630-277-9018
Practice Address - Fax:866-531-8584
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036142213207RR0500X
AZ44478207RR0500X
VA0101240331207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1205978475Medicaid
VAP00686669OtherMEDICARE RAILROAD
ILPENDINGOtherMEDICARE