Provider Demographics
NPI:1194824953
Name:AGANAD, JANET (DO)
Entity Type:Individual
Prefix:MISS
First Name:JANET
Middle Name:
Last Name:AGANAD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N YORK ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2317
Mailing Address - Country:US
Mailing Address - Phone:847-506-6622
Mailing Address - Fax:
Practice Address - Street 1:305 N YORK ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2317
Practice Address - Country:US
Practice Address - Phone:847-506-6622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036079300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036079300Medicaid
IL205315Medicare ID - Type Unspecified
IL036079300Medicaid