Provider Demographics
NPI:1962821710
Name:AGMUOS LLC
Entity type:Organization
Organization Name:AGMUOS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AYODELE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUNBIADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-451-0600
Mailing Address - Street 1:704 E 44TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-3541
Mailing Address - Country:US
Mailing Address - Phone:773-451-0600
Mailing Address - Fax:773-451-0607
Practice Address - Street 1:4850 N SAWYER AVE
Practice Address - Street 2:SUITE# 202
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5211
Practice Address - Country:US
Practice Address - Phone:773-451-0600
Practice Address - Fax:773-451-0607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care