| Agata Oczko Danguilan Md Sc | |
|
61 S Seymour Ave Grayslake IL 60030-1541 | |
| (847) 546-5600 | |
| (847) 546-5603 |
| Full Name | Agata Oczko Danguilan Md Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 61 S Seymour Ave, Grayslake, Illinois |
| Authorized Official Name and Position | Agata Oczko-danguilan (PRESIDENT) |
| Authorized Official Contact | 8475465600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agata Oczko Danguilan Md Sc 61 S Seymour Ave Grayslake IL 60030-1541 Ph: (847) 546-5600 | Agata Oczko Danguilan Md Sc 61 S Seymour Ave Grayslake IL 60030-1541 Ph: (847) 546-5600 |
| NPI Number | 1114076791 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 08/03/2024 |
| Medicare PECOS PAC ID | 4981605904 |
|---|---|
| Medicare Enrollment ID | O20070118000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114076791 | NPI | - | NPPES |
| 036112877 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036112877 (Illinois) | Primary |
| Provider Name | Agata Beata Oczko Danguilan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285701714 PECOS PAC ID: 5698790301 Enrollment ID: I20051012000197 |
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