Provider Demographics
NPI:1134939317
Name:AKUAMOAH, AGNES ADJOA (RESPIRATORY CARE)
Entity type:Individual
Prefix:
First Name:AGNES
Middle Name:ADJOA
Last Name:AKUAMOAH
Suffix:
Gender:F
Credentials:RESPIRATORY CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 E 55TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-6145
Mailing Address - Country:US
Mailing Address - Phone:312-478-4073
Mailing Address - Fax:
Practice Address - Street 1:1655 E 55TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-6145
Practice Address - Country:US
Practice Address - Phone:312-478-4073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL194001166227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGroup - Single Specialty