| Doctor Name: | DOLLY OSAS AGBA |
| NPI Number: | 1023027869 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NURSE PRACTITIONER |
| License Number: | 209-006082 |
| Business Practice Address: | 1106 Neal Ave Joliet, IL - 604332548 |
| Business Phone Number: | 8157278670 |
| Business Fax Number: | 8157408149 |
| Mailing Address: | 908 Shiloh Ct, JOLIET |
| State: | IL |
| Postal Code: | 604319307 |
| Phone Number: | 8157443481 |
| Fax Number: | 8157443481 |
| NPI Enumeration Date: | 08/07/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 209-006082 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |