Guy Agostino, M.D.
Individual provider Active NPI Family Medicine Physician · La Grange, IL
NPI 1992769822 · NPPES record last updated Aug 2, 2023
Key facts
- NPI
- 1992769822
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036075612 (IL)
- Practice address
- 512 W Burlington Ave
Suite 100
La Grange, IL 60525-2221 - Phone
- (630) 390-1240
- Fax
- (630) 390-1247
- NPI assigned
- Apr 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Loyola University of Chicago, Stritch School of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Dupage Medical Group LTD
Practice addresses (Care Compare)
512 W Burlington Ave
Suite 100
Lagrange, IL 60525-2234
Phone (708) 579-4801
Hospital & facility affiliations
- Residential Home Health
- Uchicago Medicine Adventhealth Hinsdale
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070403000145 | IL | Practitioner - Internal Medicine | 6406950302 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William H. Gros, MD,SC | Current | Accepting new patients | |
| Dupage Medical Group LTD | Current |
Accepting new patients | |
| Dupage Medical Group LTD | Current |
Accepting new patients |
Locations
30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210
1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000
512 W Burlington Ave
Ste 100
Lagrange Hlds, IL 60525
Phone (708) 579-4801
430 Warrenville Rd
Ste 210
Lisle, IL 60532
Phone (630) 432-6180
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036075612 | IL | Yes |
| Specialist | 174400000X | 036075612 | IL |
Addresses
Primary practice location
512 W Burlington Ave
Suite 100
La Grange, IL 60525-2221
Mailing address
PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036075612 | Medicaid | IL |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gagostino13278@dulyhealthandcare.direct-ci.com |
Other providers in La Grange, IL
- Adventist Midwest Health
- Adventist Midwest Health
- Adventist Midwest Health
- Adventist Midwest Health
- Aging Care Connections
- Nooreen Fatima Ahmed
- Ajl Counseling PLLC
- Sandra Al-Sakkal
- Anne Therese Albi
- Daniya Ali
All providers in La Grange, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.