Provider Demographics
NPI:1336772052
Name:DEANGELIS, MONICA (APRN, CNP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:DEANGELIS
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:RAUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:259 E ERIE ST STE 2250
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3264
Mailing Address - Country:US
Mailing Address - Phone:312-695-5620
Mailing Address - Fax:312-926-6165
Practice Address - Street 1:259 E ERIE ST STE 2250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3264
Practice Address - Country:US
Practice Address - Phone:312-695-5620
Practice Address - Fax:312-926-6165
Is Sole Proprietor?:No
Enumeration Date:2020-02-20
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.427609163WE0003X
390200000X
IL209024635363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program