| Angela E Mack, RD | |
|
2000 Lake Ave, Woodstock, IL 60098-7401 | |
| (815) 337-7100 | |
| Not Available |
| Full Name | Angela E Mack |
|---|---|
| Gender | Female |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 22 Years |
| Location | 2000 Lake Ave, Woodstock, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902991078 | NPI | - | NPPES |
| 1794-029 | Other | WI | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 1794-029 (Wisconsin) | Secondary |
| 133V00000X | Dietitian, Registered | (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aurora Medical Group, Inc. | 6709794258 | 3491 |
| Provider Name | Aurora Medical Group, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Provider Name | Lakeshore Medical Clinic Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
| Provider Name | Mercy Health System Corporation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1598718603 PECOS PAC ID: 7416860440 Enrollment ID: O20031113000164 |
| Provider Name | Aurora Advanced Healthcare, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1265629133 PECOS PAC ID: 3375625833 Enrollment ID: O20080123000694 |
| Mailing Address | Practice Location Address |
|---|---|
| Angela E Mack, RD 2000 Lake Ave, Woodstock, IL 60098-7401 Ph: (815) 337-7100 | Angela E Mack, RD 2000 Lake Ave, Woodstock, IL 60098-7401 Ph: (815) 337-7100 |
Jesell Zepeda, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 905 Hickory Rd, Woodstock, IL 60098 Phone: 815-670-4717 | |
Stacia Riffe, MS,RD,LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2125 Greenview Dr, Woodstock, IL 60098 Phone: 815-355-8237 | |
Mary Jo Winkenwerder, RD, LD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 2000 Lake Ave, Woodstock, IL 60098 Phone: 815-337-7100 Fax: 815-337-4793 | |
Jacob Miceli, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 907 Powers Rd, Woodstock, IL 60098 Phone: 815-276-9457 | |
Mrs. Tiffanie Ann Young, MS, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3701 Doty Road, Centegra Hospital - Woodstock, Woodstock, IL 60098 Phone: 815-334-3113 Fax: 815-334-3941 |