Provider Demographics
NPI:1306150305
Name:BLEECHER, ANGELA (DPT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:BLEECHER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:HAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-6200
Mailing Address - Fax:
Practice Address - Street 1:17837 80TH AVE
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-5023
Practice Address - Country:US
Practice Address - Phone:708-342-2500
Practice Address - Fax:708-342-1454
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-017957225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist