Provider Information for 1497150908
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ANGELE VILLALOBOS
Sex: Female
NPI: 1497150908
Last Updated: 2025-03-01
Certification Date: 2025-03-01
Certification Date: 2025-03-01
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1497150908 | ||||||||
| Enumeration Date | 2014-10-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1090 PICKWICK DR ROCHELLE, IL 61068-1098 United States Phone: 815-517-8386 | Fax: | ||||||||
| Primary Practice Address | 1500 E LINCOLN HWY # 1 DEKALB, IL 60115-3990 United States Phone: 779-201-8006 | Fax: | ||||||||
| Secondary Practice Address(es) | 604 N MAIN ST 555 FAIRVIEW DR | ||||||||
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