1942293402 NPI number — DR. ANGELA JEANNE SILVA DC

Table of content: DR. ANGELA JEANNE SILVA DC (NPI 1942293402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942293402 NPI number — DR. ANGELA JEANNE SILVA DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILVA
Provider First Name:
ANGELA
Provider Middle Name:
JEANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MULLETT-SILVA
Provider Other First Name:
ANGELA
Provider Other Middle Name:
JEANNE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942293402
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24W500 MAPLE AVE
Provider Second Line Business Mailing Address:
#105
Provider Business Mailing Address City Name:
NAPERVILLE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60540-6055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-428-4300
Provider Business Mailing Address Fax Number:
630-428-4305

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24W500 MAPLE AVE
Provider Second Line Business Practice Location Address:
#105
Provider Business Practice Location Address City Name:
NAPERVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60540-6055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-428-4300
Provider Business Practice Location Address Fax Number:
630-428-4305
Provider Enumeration Date:
08/30/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)