Individual
AGNES HARMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
19550 GOVERNORS HWY, SUITE 2000, FLOSSMOOR, IL 60422-2125
(708) 957-8750
(708) 957-8602
Mailing address
27702 NETWORK PL, CHICAGO, IL 60673-1277
(708) 957-8750
(708) 957-8602
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
209.010552
IL
364SA2200X
Adult Health Clinical Nurse Specialist
70000176A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200532770
—
IN
01
—
F400437514
MEDICARE
IL
01
—
P01325484
RR MEDICARE
IL
Enumeration date
04/14/2006
Last updated
02/18/2019
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