Provider Demographics
NPI:1871114819
Name:ANGONE, ASHLEY
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:
Last Name:ANGONE
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 1:6608 106TH PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415-1813
Mailing Address - Country:US
Mailing Address - Phone:708-819-0733
Mailing Address - Fax:
Practice Address - Street 1:6608 106TH PL
Practice Address - Street 2:
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-1813
Practice Address - Country:US
Practice Address - Phone:708-819-0733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician