Healthcare Provider Details

I. General information

NPI: 1568494987
Provider Name (Legal Business Name): CHRIS D'AGOSTINO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1786 MOON LAKE BLVD SUITE 104
HOFFMAN ESTATES IL
60194-5029
US

IV. Provider business mailing address

1786 MOON LAKE BLVD SUITE 104
HOFFMAN ESTATES IL
60194-5029
US

V. Phone/Fax

Practice location:
  • Phone: 847-755-8090
  • Fax: 847-843-7393
Mailing address:
  • Phone: 847-755-8090
  • Fax: 847-843-7393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number336-071573
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number336-071573
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: