Provider Demographics
NPI:1356463897
Name:CANTRE, AGNIESZKA G
Entity type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:G
Last Name:CANTRE
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:AGNIESZKA
Other - Middle Name:G
Other - Last Name:NAGPAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:68 W DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-3758
Mailing Address - Country:US
Mailing Address - Phone:847-541-3334
Mailing Address - Fax:
Practice Address - Street 1:6201 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3888
Practice Address - Country:US
Practice Address - Phone:708-636-9393
Practice Address - Fax:708-636-2022
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.149194207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology