Provider Demographics
NPI:1730664871
Name:YAGUNIC, KATHRYN (AGNP-BC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:YAGUNIC
Suffix:
Gender:F
Credentials:AGNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 W MEDICAL CENTER DR STE 1
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-8425
Mailing Address - Country:US
Mailing Address - Phone:815-759-8100
Mailing Address - Fax:815-759-8106
Practice Address - Street 1:4305 W MEDICAL CENTER DR STE 1
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8425
Practice Address - Country:US
Practice Address - Phone:815-759-8100
Practice Address - Fax:815-759-8106
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209017807363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner