Individual provider Active NPI

Angela Gallo, LCSW

  • Clinical Social Worker
  • East Dundee, IL
National Provider Identifier
1952548372
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149013325 Issued in IL
Practice address
514 King Ave
East Dundee, IL 60118-3046
Phone
(630) 400-5083
NPI assigned
Jan 8, 2009
Last updated
Dec 9, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149013325 IL Primary

Addresses

Primary practice location

514 King Ave
East Dundee, IL 60118-3046

Mailing address

514 King Ave
East Dundee, IL 60118-3046
Phone (630) 400-5083

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149013325ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481241600000",
    "number": "1952548372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 KING AVE",
            "city": "EAST DUNDEE",
            "state": "IL",
            "postal_code": "601183046",
            "telephone_number": "630-400-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 KING AVE",
            "city": "EAST DUNDEE",
            "state": "IL",
            "postal_code": "601183046",
            "telephone_number": "630-400-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLO",
        "first_name": "ANGELA",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-08",
        "last_updated": "2016-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Dundee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.