Provider Demographics
NPI:1952161978
Name:BARNER, ANGELA L
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:L
Last Name:BARNER
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 1:20200 GOVERNORS DR # 370
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1032
Mailing Address - Country:US
Mailing Address - Phone:708-800-4599
Mailing Address - Fax:
Practice Address - Street 1:20200 GOVERNORS DR # 370
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1032
Practice Address - Country:US
Practice Address - Phone:708-800-4599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106-10120246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy