Angela Christine Leeser, MSW, LCSW

Individual provider Active NPI Social Worker · Pingree Grove, IL

NPI 1821354879 · NPPES record last updated Apr 4, 2012

Key facts

NPI
1821354879
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
149.011504 (IL)
Practice address
1125 Wester Blvd
Pingree Grove, IL 60140-2044
Phone
(773) 616-4310
Fax
(866) 209-6747
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
149.011504ILMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 149.011504 IL Yes

Addresses

Primary practice location

1125 Wester Blvd
Pingree Grove, IL 60140-2044

Mailing address

P.O. Box 511
Hampshire, IL 60140-0511
Phone (773) 616-4310

Other providers in Pingree Grove, IL

All providers in Pingree Grove, IL · Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.