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Angela Atwater

Social Worker

Behavioral Health & Social Service Providers

1165 N Clark St, Suite 413, Chicago, IL 60610-2702

PECOS Enrollment

Based on the most recent information from CMS, provider Angela Atwater is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1508954785
Provider Type
Individual
Full Name
Atwater, Angela
Credential
LCSW

Gender
Female
Sole Proprietor
Yes
Enumeration Date
10/11/2006
Last Updated
10/18/2009

Contact Information

Practice Location

1165 N Clark St, Suite 413, Chicago, IL 60610-2702

(773) 456-9080

Unlisted Fax

Mailing Location

2312 W North Ave, #4e, Chicago, IL 60647-6264

(773) 456-9080

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 149010512 Illinois

Angela Atwater

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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