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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992769822 NPPES
Illinois MEDICAID 036075612

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