Peter Agostino
Individual provider Active NPI Professional Counselor · Evanston, IL
NPI 1013568989 · NPPES record last updated Sep 23, 2019
Key facts
- NPI
- 1013568989
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 178010832 (IL)
- Practice address
- 1327 Ashland Ave Apt 1
Evanston, IL 60201-6805 - Phone
- (574) 876-6235
- NPI assigned
- Sep 23, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178010832 | IL | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 178010832 | IL | Yes |
Addresses
Primary practice location
1327 Ashland Ave Apt 1
Evanston, IL 60201-6805
Mailing address
1327 Ashland Ave Apt 1
Evanston, IL 60201-6805
Phone (574) 876-6235
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- Meghana Agni
- Lorraine Aguada
- Mark Perez Agustin
- Obrain U Agwanihu
- Elizabeth Ahlgrimm
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All providers in Evanston, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.