| Organization Name: | AGATA OCZKO DANGUILAN MD SC |
| NPI Number: | 1114076791 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AGATA OCZKO-DANGUILAN (PRESIDENT) |
| Mailing Address: | 2 E Rollins Rd Suite 204 Round Lake Beach |
| State: | IL US |
| Postal Code: | 600733808 |
| Phone Number: | 8475465600 |
| Fax Number: | 8475465603 |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 11/19/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |