NPIMap

Individual provider Active NPI

Agata Oczko-Danguilan, M.D.

  • Internal Medicine Physician
  • Grayslake, IL
National Provider Identifier
1285701714
Registry record updated Aug 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036112877 Issued in IL
Practice address
61 S Seymour Ave
Grayslake, IL 60030-1541
Phone
(847) 546-5600
Fax
(847) 546-5603
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036112877 IL Primary

Addresses

Primary practice location

61 S Seymour Ave
Grayslake, IL 60030-1541

Mailing address

61 S Seymour Ave
Grayslake, IL 60030-1541
Phone (847) 546-5600

Other identifiers 1

IdentifierTypeStateIssuer
036112877MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aoczkodanguilan235482@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051012000197 IL Practitioner - Internal Medicine 5698790301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

61 S Seymour Ave
Grayslake, IL 60030-1541
Phone (847) 546-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036112877ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Agata Oczko Danguilan MD SC CurrentSince Jan 1, 2007 Accepting new patients
Irina K. Harag, M.D., LTD PastSince Apr 1, 2024 Accepting new patients
Advanced Medical and Rehabilitation LTD PastSince Sep 1, 2005 Accepting new patients

Locations

61 S Seymour Ave
Grayslake, IL 60030
Phone (847) 546-5600

2 E Rollins Rd
Ste 204
Round Lake Beach, IL 60073
Phone (847) 546-5600

Interoperability endpoints

  • Direct secure messaging: agata.oczko-danguilan.1@1392.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1392/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722643200000",
    "number": "1285701714",
    "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": {
        "last_name": "OCZKO-DANGUILAN",
        "first_name": "AGATA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036112877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112877",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aoczkodanguilan235482@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "61 S Seymour Ave",
            "city": "Grayslake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600301541",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "61 S Seymour Ave",
            "city": "Grayslake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600301541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

Verify at the official NPI Registry.