Agata Oczko Danguilan MD SC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036112877 Issued in IL

Legal business name

AGATA OCZKO DANGUILAN MD SC

Practice address

61 S Seymour Ave
Grayslake, IL 60030-1541

Phone

(847) 546-5600

Fax

(847) 546-5603

NPI assigned

Jan 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Agata Oczko-Danguilan, M.D.NPI 1285701714

Title

President

Phone

(847) 546-5600

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1392/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Agata Oczko-Danguilan, M.D.

  • Internal Medicine Physician
  • Grayslake, IL
  • NPI 1285701714
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722643200000",
    "number": "1114076791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 S SEYMOUR AVE",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301541",
            "telephone_number": "847-546-5600",
            "fax_number": "847-546-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 S SEYMOUR AVE",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301541",
            "telephone_number": "847-546-5600",
            "fax_number": "847-546-5603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGATA OCZKO DANGUILAN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A",
        "authorized_official_last_name": "OCZKO-DANGUILAN",
        "authorized_official_first_name": "AGATA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-546-5600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036112877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112877",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.