Provider Demographics
NPI:1639956147
Name:AGMB HEALTHCARE GROUP LLC
Entity Type:Organization
Organization Name:AGMB HEALTHCARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNN
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:224-517-6010
Mailing Address - Street 1:1100 E RANDVILLE DR UNIT 203
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-2915
Mailing Address - Country:US
Mailing Address - Phone:224-517-6010
Mailing Address - Fax:
Practice Address - Street 1:1100 E RANDVILLE DR UNIT 203
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-2915
Practice Address - Country:US
Practice Address - Phone:224-517-6010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare