Provider Demographics
NPI:1346388063
Name:JOLIET SURGICARE, P.C.
Entity Type:Organization
Organization Name:JOLIET SURGICARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:AGNICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-744-3338
Mailing Address - Street 1:PO BOX 2577
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60434-2577
Mailing Address - Country:US
Mailing Address - Phone:815-744-3338
Mailing Address - Fax:815-744-8471
Practice Address - Street 1:330 MADISON ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6565
Practice Address - Country:US
Practice Address - Phone:815-744-3338
Practice Address - Fax:815-744-8471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty