| Aagaard 5 Llc | |
|
2001 N Gary Ave Suite 210 Wheaton IL 60187-3055 | |
| (630) 614-4255 | |
| (630) 614-4059 |
| Full Name | Aagaard 5 Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2001 N Gary Ave, Wheaton, Illinois |
| Authorized Official Name and Position | Jon Potter Aagaard (PRESIDENT) |
| Authorized Official Contact | 6306144255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aagaard 5 Llc 2001 N Gary Ave Suite 210 Wheaton IL 60187-3055 Ph: (630) 614-4255 | Aagaard 5 Llc 2001 N Gary Ave Suite 210 Wheaton IL 60187-3055 Ph: (630) 614-4255 |
| NPI Number | 1285900753 |
|---|---|
| Provider Enumeration Date | 03/28/2012 |
| Last Update Date | 07/01/2015 |
| Medicare PECOS PAC ID | 9133384233 |
|---|---|
| Medicare Enrollment ID | O20120622000057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285900753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036058975 (Illinois) | Primary |
| Provider Name | Jon Potter Aagaard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750496923 PECOS PAC ID: 6103870969 Enrollment ID: I20100827000248 |
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