Individual
MR. EMMANUEL N AGOMO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
240 E LAKE ST, SUITE 200, ADDISON, IL 60101-2890
(630) 941-9344
(630) 941-1486
Mailing address
240 E LAKE ST, SUITE 200, ADDISON, IL 60101-2890
(630) 776-1595
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
85002328
IL
Other
Enumeration date
05/23/2006
Last updated
07/08/2007
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