Angelica Cornejo LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ANGELICA CORNEJO LLC

Practice address

10725 S Western Ave
Chicago, IL 60643-3217

Phone

(773) 270-1042

NPI assigned

Dec 7, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Angelica CornejoNPI 1568834158

Title

Owner

Phone

(773) 331-4029

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angelica Cornejo, LCPC

  • Professional Counselor
  • Chicago, IL
  • NPI 1568834158
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670371200000",
    "number": "1285345678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1318 W 107TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606433632",
            "telephone_number": "773-331-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10725 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606433217",
            "telephone_number": "773-270-1042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELICA CORNEJO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A",
        "authorized_official_last_name": "CORNEJO",
        "authorized_official_first_name": "ANGELICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-331-4029"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.