Provider Demographics
NPI:1285812438
Name:ANGELA S. LIMA S.C.
Entity type:Organization
Organization Name:ANGELA S. LIMA S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:708-579-9223
Mailing Address - Street 1:429 S PECK AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-6127
Mailing Address - Country:US
Mailing Address - Phone:708-579-9223
Mailing Address - Fax:
Practice Address - Street 1:6733 KINGERY HWY
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-5142
Practice Address - Country:US
Practice Address - Phone:630-850-0600
Practice Address - Fax:630-850-0608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty