Angelia Dotson
Individual provider Active NPI Homemaker · Belleville, IL
NPI 1629464136 · NPPES record last updated Apr 10, 2015
Key facts
- NPI
- 1629464136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Homemaker 376J00000X
- License
- 1504015 (IL)
- Practice address
- 210 S Church St
Apt 2a
Belleville, IL 62220-2266 - Phone
- (618) 606-3734
- NPI assigned
- Apr 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1504015 | IL | MD | Homemaker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chore Provider | 372500000X | 1504015 | IL | |
| Adult Companion | 372600000X | 1504015 | IL | |
| Home Health Aide | 374U00000X | 1504015 | IL | |
| Homemaker | 376J00000X | 1504015 | IL | Yes |
Addresses
Primary practice location
210 S Church St
Apt 2a
Belleville, IL 62220-2266
Mailing address
PO Box 304
East Saint Louis, IL 62202-0304
Phone (618) 606-3734
Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.