Individual provider Active NPI

Guy Agostino, M.D.

  • Family Medicine Physician
  • La Grange, IL
National Provider Identifier
1992769822
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036075612 Issued in 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
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036075612 IL Primary
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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gagostino13278@dulyhealthandcare.direct-ci.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070403000145 IL Practitioner - Internal Medicine 6406950302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

512 W Burlington Ave
Suite 100
Lagrange, IL 60525-2234
Phone (708) 579-4801

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036075612ILMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
William H. Gros, MD,SC Current Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 1, 2011 Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 1, 2011 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

Interoperability endpoints

  • Direct secure messaging: gagostino13278@dulyhealthandcare.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1992769822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 W BURLINGTON AVE",
            "address_2": "SUITE 100",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252221",
            "telephone_number": "630-390-1240",
            "fax_number": "630-390-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGOSTINO",
        "first_name": "GUY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036075612",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036075612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gagostino13278@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "512 W Burlington Ave",
            "address_2": "Suite 100",
            "city": "LA Grange",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605252221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in La Grange, IL

Sources for this page

Verify at the official NPI Registry.