Agostino, Guy
Agostino, Guy is an individual health care provider with primary practice located at 512 W Burlington Ave Suite 100, La Grange IL 60525-2221. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Agostino, Guy can be contacted via phone (630) 390-1240.Contact Information
Primary practice address
512 W Burlington Ave Suite 100
La Grange IL 60525-2221
Phone: (630) 390-1240
Fax: (630) 390-1247
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036075612 | Illinois |
Other Service Providers / Specialist | 174400000X | 036075612 | Illinois |
Profile Details
NPI number | 1992769822 |
---|---|
LBN Legal business name | Agostino, Guy |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 17th, 2006 |
Last updated | Aug 2nd, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1992769822 | NPPES |
Illinois | MEDICAID | 036075612 |
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