Healthcare Provider Details

I. General information

NPI: 1932742541
Provider Name (Legal Business Name): AGHAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2019
Last Update Date: 12/08/2019
Certification Date: 12/08/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5683 N MILWAUKEE AVE
CHICAGO IL
60646-6220
US

IV. Provider business mailing address

6101E N SHERIDAN RD UNIT 37B
CHICAGO IL
60660-6825
US

V. Phone/Fax

Practice location:
  • Phone: 773-273-1447
  • Fax:
Mailing address:
  • Phone: 773-273-1447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHERIF DAWOOD
Title or Position: MD/ORGANIZER
Credential: MD
Phone: 714-944-8253