Provider Demographics
NPI:1376550442
Name:NAGAJ, EGUERT (MD)
Entity Type:Individual
Prefix:
First Name:EGUERT
Middle Name:
Last Name:NAGAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W DUNDEE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-3545
Mailing Address - Country:US
Mailing Address - Phone:847-243-0355
Mailing Address - Fax:847-243-0356
Practice Address - Street 1:333 W DUNDEE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-3545
Practice Address - Country:US
Practice Address - Phone:847-243-0355
Practice Address - Fax:847-243-0356
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-106724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036106724Medicaid
213162Medicare ID - Type Unspecified
H64344Medicare UPIN