| Doctor Name: | MARLENE ANGELICO |
| NPI Number: | 1013128750 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | |
| Business Practice Address: | 2650 Ridge Ave Emergency Medicine, Rm G903c Evanston, IL - 602011718 |
| Business Phone Number: | 8475701355 |
| Business Fax Number: | 8475701223 |
| Mailing Address: | 2650 Ridge Ave, Evanston Hospital EVANSTON |
| State: | IL |
| Postal Code: | 602011718 |
| Phone Number: | 8475701206 |
| Fax Number: | 8475701248 |
| NPI Enumeration Date: | 05/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |