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

LicenseStateTypeSpecialty
178010832ILMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Evanston, IL

All providers in Evanston, IL · Professional Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.